Major approaches and clinical findings of cataract surgery using the femtosecond laser: a systematic review

Abstract

Introduction: In the scenario of eye problems, cataract is a disease characterized by the opacification of the lens, which leads to a decrease in visual acuity, due to a change in the refractive index. A cataract is the leading cause of blindness worldwide and surgery for its correction is the most performed surgical procedure in the world, with an estimated 19 million surgeries per year. The Femtosecond laser was approved for ophthalmic surgery in 2000, having been recently developed to integrate cataract surgery. Objective: It was to highlight the main clinical and scientific considerations related to the application of the Femtosecond laser in cataract surgery, highlighting its efficacy and safety to the conventional phacoemulsification technique. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from the last 15 years. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 229 articles were found, of which only 55 were part of this systematic review, after an eligibility analysis. Femtosecond laser-assisted cataract surgery appears to be beneficial in some patient groups, ie those with low baseline endothelial cell counts, or those planning to receive multifocal intraocular lenses. However, considering that the advantages of femtosecond laser-assisted cataract surgery may not be clear in all routine cases, it cannot be considered cost-effective. The adoption of the Femtosecond laser in cataract surgery has divided opinions as it results from the adaptation of a technology already used in other areas to a surgical procedure that, at the time, was already successful.