Contralateral eye comparison of the phacoemulsification metrics, patient experience and clinical outcomes in patients undergoing bilateral cataract surgery with two commonly used femtosecond laser systems

Abstract

PurposeThe purpose of the study was to compare phacometrics, patient experience factors and clinical outcomes in patients undergoing bilateral laser-assisted cataract surgery using two common femtosecond laser platforms.SettingThis study was conducted in Beverly Hills Institute of Ophthalmology, Beverly Hills, California, USA.Study designThis was a prospective, comparative, contralateral eye study.MethodsFemtosecond laser-assisted cataract surgery was performed in the first eye of 50 patients with bilateral cataract (mean age 69.9 ± 8.61 years) using either the Catalys (Johnson & Johnson Vision) or the LenSx (Alcon Laboratories, Inc.) laser system. The fellow eye was treated with the laser not used in the first eye. The primary outcome measures included overall procedural times, and the secondary outcome measures included patient experience with the two laser systems.ResultsThere were no statistical differences between the two groups in terms of patient interface preparation time and number of docking attempts as well as effective phaco time, average phaco power, total ultrasound time and nucleus removal time. However, the LenSx group demonstrated a significantly longer cortex removal time and higher perception of pressure and vision loss (p < 0.001) compared to the Catalys group. A significantly higher number of Catalys eyes achieved complete capsulotomy (p < 0.001). The ease of cortex removal was also better in the Catalys group. Postoperative visual acuity, keratometry, endothelial cell count and intraocular pressure were comparable in the two groups.ConclusionWith similar phacometric and clinical outcomes, both laser platforms were efficient, safe and effective during cataract surgery; however, the Catalys group demonstrated superior outcomes in terms of the patient experience, completeness of capsulotomy and ease of cortex removal.

Surgical outcomes with high and low pulse energy femtosecond laser systems for cataract surgery

“…Consistent with these findings, the incidence of subconjunctival hemorrhage was found to be significantly higher with contact corneal applanation based LenSx group, compared to Z8 group that employs non-applanation fluid filled patient interface (63% vs 1%; p < 0.001) in this study. Similarly, previous publications also reported significantly lower incidence of sub-conjunctival hemorrhage with liquid interface systems, compared to CCL interface system 15 , 28 . With the availability of advanced presbyopia correcting intraocular lens (IOLs) and changing practice patterns, there is a gradual shift in age of the patients undergoing cataract/refractive lens exchange surgeries.…”

Comparing the time efficiency of two lasers used in FLACS: real-world observational study

“…Our study also took a multicenter approach involving a larger number of procedures and using regression modeling to account for inherent differences in the 2 groups of patients, minimizing biases and offering more generalizable results. 14,15 This study has several practice-level implications. As it stands, demand for cataract surgery is increasing in the United States, and the labor shortage of ophthalmologists is expected to total over 6000 in 2025.…”

“…However, contextualizing these time savings is challenging given this study did not examine the total time in the laser room and thus should be explored in future research. 14 By contrast, a more recent study by Khodabakhsh and Hofbauer (2018) reported no significant differences between the LenSx and CATALYS systems in patient interface preparation time, phacoemulsification time, total imaging time, nucleus removal time, phacoemulsification power, and number of docking attempts; however, the LenSx system had significantly shorter suction times (108.5 seconds) compared with the CATALYS system (123.2 seconds) (P < .05). 15 Currently, there are no studies directly comparing laser systems on the total time spent in the femtosecond laser room in the United States.…”

“…14 By contrast, a more recent study by Khodabakhsh and Hofbauer (2018) reported no significant differences between the LenSx and CATALYS systems in patient interface preparation time, phacoemulsification time, total imaging time, nucleus removal time, phacoemulsification power, and number of docking attempts; however, the LenSx system had significantly shorter suction times (108.5 seconds) compared with the CATALYS system (123.2 seconds) (P < .05). 15 Currently, there are no studies directly comparing laser systems on the total time spent in the femtosecond laser room in the United States. Given the increased demand for cataract surgeries within their respective practices, a study comparing the time and efficiencies associated with different laser systems in the procedure room would provide significant value to practices looking to more reliably predict overall procedure times, patient flow, and patient volume.…”

Argentinian flag sign during refractive laser-assisted cataract surgery – A case report

“…In comparison to other platforms, the Catalys™ Precision Laser System has been reported as a robust laser system, demonstrating superiority in complete capsulotomy when compared to the LenSx laser platform. 19 , 20 , 21 , 22 Conrad-Hengerer et al, evaluated the use of femtosecond laser–assisted capsulotomy in eyes with intumescent cataract using the Catalys™ Precision Laser System and concluded that FLACS was safe to avoid intraoperative capsule complications related to increased intracapsular pressure. 23 …”