Femtosecond laser–assisted cataract surgery: A review

Roberts, Harry W; Day, Alexander C; O’Brart, David PS

doi:10.1177/1120672119893291

Cited by 42 publications

(34 citation statements)

References 121 publications

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“… 79 While it offers potential advantages in terms of automation of some of the surgical steps of cataract surgery, clinical outcomes appear to be no better than those with PCS. 80 , 81 At present there is limited evidence on the long-term effects of FLACS on the ocular surface, although there are a number of studies which indicate that akin to PCS, FLACS also leads to signs and symptoms of DED. 82 , 83 …”

Section: The Pathophysiology Of Cataract Surgery Associated Dedmentioning

confidence: 99%

Cataract surgery and dry eye disease: A review

Naderi

Gormley

O’Brart

2020

European Journal of Ophthalmology

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Aim To review published literature concerning cataract surgery and dry eye disease (DED). Methods A search was undertaken using the following: PubMed (all years), Web of Science (all years), Ovid MEDLINE(R) (1946 to 12 December 2019), Ovid MEDLINE(R) Daily Update 10 December 2019, MEDLINE and MEDLINE non-indexed items, Embase (1974–2019, week 49), Ovid MEDLINE (R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations and Daily (1946 to 12 December 2019), CENTRAL (including Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 12 of 12 December 2019), metaRegister of Controlled Trials (mRCT) ( www.controlled-trials.com ), ClinicalTrials.gov ( www.clinicaltrial.gov ) and WHO International Clinical Trials Registry Platform ( www.who.int/ictrp/search/en ). Search terms included ‘cataract surgery’, ‘phacoemulsification’ and ‘cataract extraction’, combined with ‘dry eyes’ and ‘ocular surface’. Relevant in-article references not returned in our searches were also considered. Results Publications identified included systematic reviews, meta-analysis, randomized controlled trials, cohort studies, case series and laboratory-based studies. Published data highlighting the burden of DED both prior and following cataract surgery were reviewed as well as studies highlighting the effects of cataract surgery on the ocular surface, intra-operative measures to reduce deleterious effects on the ocular surface and current evidence on the management options of post-operative DED. Conclusions DED is common and can be exacerbated by cataract surgery. Ophthalmologists need to assess for pre-existing DED and instigate treatment before surgery; be aware of reduced accuracy of measurements for surgical planning in the presence of DED; limit intra-operative surgical factors damaging to the ocular surface; and consider management to reduce DED post-operatively.

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Section: The Pathophysiology Of Cataract Surgery Associated Dedmentioning

confidence: 99%

Cataract surgery and dry eye disease: A review

Naderi

Gormley

O’Brart

2020

European Journal of Ophthalmology

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“…The prevalence of clinically significant cataract is about 93 percent in patients aged 80 or older and influenced the visual function of approximately 95 million people in 2014 [ 2 ]. The current management of visually disturbed cataract is via surgery, such as phacoemulsification or manual small-incision cataract surgery [ 3 , 4 ], and the femtosecond laser device can be applied in certain cases [ 5 , 6 ]. Although the general success rate is high for cataract surgery, certain visual-threatening complications can still occur, including cystoid macular edema, pseudophakic bullous keratopathy, retinal detachment, and postoperative endophthalmitis [ 1 , 2 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Predisposing Factors for Severe Complications after Cataract Surgery: A Nationwide Population-Based Study

Lin

Lee

Chen

et al. 2021

JCM

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We conducted a retrospective group study to evaluate the potential systemic risk factors for major postoperative complications of cataract surgery. Individuals diagnosed with (n = 2046) and without (n = 8184) serious complications after cataract surgery were matched 1:4 for age, sex, and index date obtained using Taiwan’s National Health Insurance Research Database. The outcome was defined as at least one new inpatient or outpatient diagnosis of systemic disease one year before the index date. The effect of demographic data on postoperative complications was also analyzed in the multivariable model. Data were analyzed using univariate and multivariate conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals of the risk of developing serious complications. After the entire study interval, the major postoperative complications of cataract surgery were associated with the following systemic diseases: hypertension (adjusted OR (aOR) = 2.329, p < 0.001), diabetes mellitus (aOR = 2.818, p < 0.001), hyperlipidemia (aOR = 1.702, p < 0.001), congestive heart failure (aOR = 2.891, p < 0.001), rheumatic disease (aOR = 1.965, p < 0.001), and kidney disease needing hemodialysis (aOR = 2.942, p < 0.001). Additionally, demographic data including old age, higher urbanization level, higher level of care, and more frequent inpatient department visits were associated with a higher rate of postoperative complications. In conclusion, metabolic syndrome, chronic heart failure, end-stage renal disease, rheumatic disease, older age, and frequent inpatient department visits are correlated with the development of severe postoperative complications of cataract surgery. Therefore, cataract surgery patients should be informed about a higher possibility of postoperative complications.

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“…[27][28][29] This study demonstrates that although femtosecond laser made the surgical steps of cataract surgery more predictable, it still has to be further studied in large multicenter studies to justify the benefits against the high cost of the technology, particularly many recent studies concluded that there was no statistically significant difference between FLACS and standard phacoemulsification in terms of visual outcomes and complications. [30][31][32]…”

Section: Discussionmentioning

confidence: 99%