LISBON, Portugal — The FEMCAT study, a large, real-life, prospective, multicenter study comparing femtosecond laser cataract surgery and phacoemulsification, showed equal results and complications between the two procedures.
“We did not observe any specific issue related to the laser procedure, we did not observe any statistical difference between femto and phaco for all outcome measures, and whatever small difference was found is far beyond any clinical significance for the patient,” Cedric Schweitzer, MD, said at the European Society of Cataract and Refractive Surgeons meeting, where results were first disclosed.
The study was fully granted by the French Ministry of Health and had a robust methodology to limit selection bias. In each of the five centers involved — Bordeaux, Paris, Lyon, Tours and Brest — four surgeons specialized in cataract surgery were selected. A total of 756 eyes were allocated to the femto arm and 752 to the phaco arm.
“As it was a real-life study, we involved surgeons of different age, training and experience, but standardized the surgical techniques. All patients were implanted [with] a standard 6-mm hydrophobic acrylic IOL,” Schweitzer said.
Significant improvements in visual acuity and refraction were observed in the two arms, with no significant differences between femto and phaco. No complication specifically related to the laser procedure occurred intraoperatively. At the stage of phacoemulsification, there was a very similar rate of posterior capsule rupture, vitreous loss, crystalline lens luxation or subluxation, and zonular dialysis in the two arms, “with no trend at all,” Schweitzer said. There was a slight trend to a lower rate of postoperative cystoid macular edema in the femto group, and astigmatism outcomes were not significantly different. The overall success rate of the two procedures was equal.
“It is probably fair to still say that femto could be a new paradigm. It is not better or worse,” Schweitzer said. “Can we expect advances in femtosecond laser technology that might improve clinical significance? Probably, though it seems that the technology is already optimized. Association with other innovations would be important to take advantage of the very precise femtosecond cutting ability and provide clinical significance.” – by Michela Cimberle
Schweitzer C. Evidence from the French FEMCAT study. Presented at European Society of Cataract and Refractive Surgeons meeting; Oct. 7-11, 2017; Lisbon, Portugal.
Disclosure: Schweitzer reports no relevant financial disclosures.