Safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: A meta-analysis and systematic review

Xu, Junjie; Chen, Xinyi; Wang, Hanle; Yao, Ke

doi:10.1016/j.aopr.2022.100027

Cited by 3 publications

(2 citation statements)

References 54 publications

(114 reference statements)

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“…With the rapid development of the laser, recently, femtosecond laser-assisted cataract surgery (FLACS) has become an important development in the history of cataract surgery. Many clinical studies showed that FLACS offered the perfection of the capsulorhexis and long-term stability of the effective lens position of FLACS, which provided more predictable refractive outcomes (12,(19)(20)(21). These were the significant advantages that manual surgery cannot achieve (20).…”

Section: Cataractmentioning

confidence: 99%

Grand Challenges and Opportunities in Surgical Ophthalmology: Together for a Shared Future

et al. 2022

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Section: Cataractmentioning

confidence: 99%

Grand Challenges and Opportunities in Surgical Ophthalmology: Together for a Shared Future

et al. 2022

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“…[4][5][6] Several studies have shown the notable benefits of this technology, including the increased precision of anterior capsulotomies, less intraocular lens (IOL) tilt and decentration, and substantial reductions in ultrasound power and effective phacoemulsification time (EPT). [7][8][9][10] FLACS alleviates endothelial cell damage and early postoperative corneal swelling, which leads to a faster visual recovery. [11][12][13] Several randomised controlled trials demonstrated that FLACS and conventional phacoemulsification cataract surgery (CPCS) could achieve the same outcomes in terms of vision, refraction and patientreported health.…”

Section: Introductionmentioning

confidence: 99%

Incidence and analysis of intraoperative complications in femtosecond laser-assisted cataract surgery: a large-scale cohort study to establish the learning curve

Zhang,

Xu,

Shentu

et al. 2024

Br J Ophthalmol

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AimsTo assess the safety of femtosecond laser-assisted cataract surgery (FLACS) based on surgical parameters and intraoperative complications analysis and to determine the length of the learning curve for FLACS.MethodsA prospective consecutive cohort study was conducted on Chinese patients who underwent either FLACS (3289 cases) or contemporaneous conventional phacoemulsification cataract surgery (2130 cases). The laser group was divided into four subgroups in chronological order. We recorded intraoperative complication incidences and compared with surgical parameters between groups. Subgroup analysis was conducted to explore the learning curve of FLACS.ResultsThe laser group had a 4.93% incidence of incomplete capsulotomies and a 1.22% incidence of anterior capsule tears. Subgroup analysis showed significant differences in 8 aspects between the first 250 cases (50 cases per surgeon) and the last 2539 cases, but only 2 aspects differed between the second 250 cases (50 cases per surgeon) and the last 2539 cases. There were no significant differences between the third 250 cases (50 cases per surgeon) and the last 2539 cases.ConclusionsThe intraoperative complications of FLACS were reported, and the learning curve is associated with a significant reduction in the incidence of intraoperative complications. The length of the basic learning curve of FLACS is 100 cases, and the length of the advanced learning curve was 150 cases. This study demonstrated that FLACS is characterised by a relatively straightforward and secure operative technique.

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Pain perception, aqueous humour cytokines, and miosis response following first and second eye femtosecond laser‐assisted cataract surgery: A randomised, prospective, intraindividual study

Yu,

Wang,

Qiao

et al. 2024

Clinical Exper Ophthalmology

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BackgroundTo compare pain perception, pupil behaviours, and cytokine levels during first‐eye and second‐eye femtosecond laser‐assisted cataract surgery (FLACS) and determine which is better regarding a short or long interval for bilateral FLACS.MethodsNotably, 96 eyes of 48 patients with bilateral cataracts underwent the first surgeries in the left or right eye, according to a random sequence. They were further randomised into 2‐ and 6‐week subgroups based on surgery intervals. Pupil size was measured from captured images, and pain perception was assessed using a visual analog scale (VAS). Aqueous humour prostaglandin E2 (PGE2), monocyte chemoattractant protein‐1 (MCP‐1), interleukin (IL)‐6, and IL‐8 levels were also quantitatively analysed. All patients were followed for 1 week to evaluate changes in endothelial cell density (ECD), central corneal thickness (CCT), and macular central subfield thickness (CST).ResultsOcular pain was significantly higher in patients who underwent second‐eye FLACS. First tear break‐up time was negatively correlated with VAS score. MCP‐1 levels were significantly higher in patients who underwent second‐eye FLACS, and VAS scores were positively correlated with MCP‐1 levels across all patients. There were no differences between sequential FLACS in miosis, PGE2, IL‐6, IL‐8 levels and changes in postoperative ECD, CCT, and CST. Patients who underwent second‐eye FLACS after 6 weeks showed more CCT, CST, and MCP‐1 changes than baseline.ConclusionSecond‐eye FLACS causes more pain and upregulated MCP‐1. There was no difference between sequential FLACS in PGE2 levels, miosis, and postoperative inflammation. Furthermore, first‐eye FLACS triggered a sympathetic irritation, particularly after a 6‐week interval.

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Safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: A meta-analysis and systematic review

Cited by 3 publications

References 54 publications

Grand Challenges and Opportunities in Surgical Ophthalmology: Together for a Shared Future

Grand Challenges and Opportunities in Surgical Ophthalmology: Together for a Shared Future

Incidence and analysis of intraoperative complications in femtosecond laser-assisted cataract surgery: a large-scale cohort study to establish the learning curve

Pain perception, aqueous humour cytokines, and miosis response following first and second eye femtosecond laser‐assisted cataract surgery: A randomised, prospective, intraindividual study

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