Assessment of surgeon experience with femtosecond laser-assisted cataract surgery

Abstract

PurposeTo evaluate the collective user experience with an image-guided femtosecond laser (FSL) for cataract surgery in a high-volume, multi-surgeon, ambulatory surgical center.Subjects and methodsA detailed online survey was distributed to all surgeons in a single ambulatory surgical center who had performed cataract surgery using a FSL since its acquisition in December 2012. Information collected included the number of cases performed, typical surgical techniques and parameters, satisfaction with individual features of the laser (rated on a scale from 1=completely unsatisfied to 10=extremely satisfied) and commentary on ease of use and suggested improvements.ResultsSeventeen of 30 surgeons (56.7%) completed the survey, representing a case volume of 1,967 eyes. Fourteen surgeons (82.4%) felt they required ≤10 cases with the FSL to operate with the same safety and control as in standard phacoemulsification surgery. Satisfaction was highest for capsulotomies, lens fragmentation, lens softening, arcuate incisions and the graphic user interface (mean scores 9.4, 8.7, 8.7, 7.2 and 8.9, respectively). Preferred capsulotomy diameter was 4.8–5.2 mm (64.7% of respondents). About half (52.9%) of respondents centered the capsulotomy on the pupil and the other 47.1% centered the capsulotomy using optical coherence tomography. Most respondents (81.3%) preferred transepithelial arcuate incisions compared to intrastromal incisions. Satisfaction was lowest with FSL-created, main, clear corneal incisions and paracenteses (mean scores 4.4 and 4.2, respectively).ConclusionLaser-assisted cataract surgery has a short learning curve and a high rate of user satisfaction. Further software and hardware development is warranted to improve user satisfaction with peripheral and clear corneal incisions.

Femtosecond laser–assisted cataract surgery: A review

“…Indeed, in a recently published survey of FLACS user experience, only 2 of 30 surgeons routinely used FL CCIs when performing FLACS. 17…”

Femtosecond laser-assisted cataract surgery: Update and perspectives

“…Surgeons familiar with refractive femtosecond lasers may learn FLACS faster (88). Improvements in training techniques and laser software can also contribute to significantly flattening the learning curve (89). However, a survey showed that 82.4% of surgeons felt that 10 cases or less require FLACS to be performed with the same safety as PCS (90).…”

Contemporary Practices in Cataract Surgery- Subjective Preferences of Czech Cataract Surgeons

“…V rámci operačního dne 5 chirurgů standardně operuje více než 20 katarakt, 16 operuje 15-20 katarakt, 17 uvedlo 10-15 katarakt, 8 operuje 5-10 katarakt a 5 pak 1-5 katarakt. Řada kataraktových chirurgů běžně provádí také další typy očních operací -antiglaukomové (16 chirurgů), vitreoretinální (10), transplantace rohovky (11) refrakční laserové zákroky (15), refrakční nitrooční zákroky (23). Pouze 16 chirurgů uvedlo, že jiné operace neprovádějí.…”

“…Rozdílným názorům na tuto technologii odpovídá také nejednoznačnost dat v odborné literatuře. Je možné najít práce, ve kterých chirurgové hodnotí FS laser jako přínosný [11,12] i naopak [13,14].…”