Customized FLACS yields consistent outcomes

A 5-mm capsulotomy diameter was more consistently and precisely achieved in the FLACS group with significantly lower standard deviation.

BELGRADE, Serbia — Femtosecond laser-assisted cataract surgery with the Femto LDV Z8 laser offers the advantages of repeatable and precise outcomes, best placement of the capsulotomy and optimized surgical planning with the patient in one position from the beginning to end of surgery, Brigitte Pajic-Eggspuehler, MD, told colleagues at the European Society of Cataract and Refractive Surgeons winter meeting here.

“The operating time and workflow can be optimized and continuously improve with experience. We are now able to perform four to five FLACS per hour,” she said.

Pajic-Eggspuehler co-authored a prospective, single-center study published in Sensors that investigated the safety and efficacy of the LDV Z8 (Ziemer) for femtosecond laser-assisted cataract surgery (FLACS) in 68 eyes vs. conventional phacoemulsification in 62 eyes.

There were no statistically significant differences in age or preoperative best corrected visual acuity between the two groups; however, mean preoperative lens density in the FLACS group was “highly” statistically significantly thicker (P < .001) at grade 2.57 vs. grade 2.23 on the Lens Opacities Classification System III scale, according to the study.

Although cataract grade density was higher in the FLACS group, the phaco time was lower, Pajic-Eggspuehler said. Mean phaco time was 1.9 seconds in the FLACS group and 2.3 seconds in the conventional group (P = .042). However, overall surgical time was “slightly” statistically significantly shorter in the conventional group than in the FLACS group: 6.6 minutes vs. 7.5 minutes (P = .048), according to the study.

In both groups, a 5-mm capsulotomy diameter was attempted, which was more consistently and precisely achieved in the FLACS group with significantly lower standard deviation, Pajic-Eggspuehler said. Mean diameter was 5 mm in the FLACS group and 4.7 mm in the conventional group (P < .001).

Visual rehabilitation occurred significantly faster on the first postoperative day in the FLACS group, but at all time points thereafter, there were no significant differences between the two groups. Patients were followed up for 3 months.

“The overall surgery time was on average 1 minute more in the FLACS group, but experience made it progressively shorter. The time we lost for the paracentesis, capsulorrhexis and main incision, we regained during phacoemulsification and IOL implantation. The main incision is customized by the laser, and immediate insertion of the lens is possible. Irrigation and aspiration times were comparable. We also have to handle fewer instruments, and this potentially saves time,” Pajic-Eggspuehler said.

No intraoperative complications were reported.

In the United States, the LDV Z8 received 510(k) clearance in October 2015 for the following uses: Z-LASIK, Z-LASIK Z, intracorneal rings, intrastromal pockets, lamellar keratoplasty, penetrating keratoplasty, anterior keratoplasty, lens fragmentation, clear corneal incisions and arc incisions. – by Michela Cimberle and Patricia Nale, ELS

Disclosure: Pajic-Eggspuehler reports no relevant financial disclosures.

BELGRADE, Serbia — Femtosecond laser-assisted cataract surgery with the Femto LDV Z8 laser offers the advantages of repeatable and precise outcomes, best placement of the capsulotomy and optimized surgical planning with the patient in one position from the beginning to end of surgery, Brigitte Pajic-Eggspuehler, MD, told colleagues at the European Society of Cataract and Refractive Surgeons winter meeting here.

“The operating time and workflow can be optimized and continuously improve with experience. We are now able to perform four to five FLACS per hour,” she said.

Pajic-Eggspuehler co-authored a prospective, single-center study published in Sensors that investigated the safety and efficacy of the LDV Z8 (Ziemer) for femtosecond laser-assisted cataract surgery (FLACS) in 68 eyes vs. conventional phacoemulsification in 62 eyes.

There were no statistically significant differences in age or preoperative best corrected visual acuity between the two groups; however, mean preoperative lens density in the FLACS group was “highly” statistically significantly thicker (P < .001) at grade 2.57 vs. grade 2.23 on the Lens Opacities Classification System III scale, according to the study.

Although cataract grade density was higher in the FLACS group, the phaco time was lower, Pajic-Eggspuehler said. Mean phaco time was 1.9 seconds in the FLACS group and 2.3 seconds in the conventional group (P = .042). However, overall surgical time was “slightly” statistically significantly shorter in the conventional group than in the FLACS group: 6.6 minutes vs. 7.5 minutes (P = .048), according to the study.

In both groups, a 5-mm capsulotomy diameter was attempted, which was more consistently and precisely achieved in the FLACS group with significantly lower standard deviation, Pajic-Eggspuehler said. Mean diameter was 5 mm in the FLACS group and 4.7 mm in the conventional group (P < .001).

Visual rehabilitation occurred significantly faster on the first postoperative day in the FLACS group, but at all time points thereafter, there were no significant differences between the two groups. Patients were followed up for 3 months.

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“The overall surgery time was on average 1 minute more in the FLACS group, but experience made it progressively shorter. The time we lost for the paracentesis, capsulorrhexis and main incision, we regained during phacoemulsification and IOL implantation. The main incision is customized by the laser, and immediate insertion of the lens is possible. Irrigation and aspiration times were comparable. We also have to handle fewer instruments, and this potentially saves time,” Pajic-Eggspuehler said.

No intraoperative complications were reported.

In the United States, the LDV Z8 received 510(k) clearance in October 2015 for the following uses: Z-LASIK, Z-LASIK Z, intracorneal rings, intrastromal pockets, lamellar keratoplasty, penetrating keratoplasty, anterior keratoplasty, lens fragmentation, clear corneal incisions and arc incisions. – by Michela Cimberle and Patricia Nale, ELS

Disclosure: Pajic-Eggspuehler reports no relevant financial disclosures.