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Femtosecond Laser-Assisted Cataract Surgery Versus Phacoemulsification Cataract Surgery (FACT): A Randomized
Alexander C Day1, Jennifer M Burr2, Kate Bennett3
1The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom.
Femtosecond laser-assisted cataract surgery (FLACS) is as effective and safe as standard phacoemulsification cataract surgery (PCS) at 3 months. Both procedures provide comparable visual acuity, refractive outcomes, and patient-reported health benefits.
Area of Science:
- Ophthalmology
- Surgical Technology
- Clinical Trials
Background:
- Age-related cataracts affect millions globally, necessitating effective surgical interventions.
- Phacoemulsification cataract surgery (PCS) is the current standard of care.
- Femtosecond laser-assisted cataract surgery (FLACS) offers a potential alternative with enhanced precision.
Purpose of the Study:
- To compare the 3-month outcomes of FLACS versus standard PCS.
- To evaluate visual acuity, refractive targets, and safety profiles of both procedures.
Main Methods:
- A multicenter, randomized controlled trial involving 785 patients with age-related cataracts.
- Patients were randomized (1:1) to either FLACS or PCS.
- Primary outcome was unaided distance visual acuity (UDVA) at 3 months, with secondary outcomes including corrected visual acuity and complications.
Main Results:
- No significant difference in mean UDVA between FLACS and PCS at 3 months (-0.01 logMAR).
- Both methods achieved similar refractive targets: 71% within ±0.5 D and 93-92% within ±1.0 D.
- Two posterior capsule tears occurred in the PCS group, none in the FLACS group, with no other significant differences in secondary outcomes.
Conclusions:
- Femtosecond laser-assisted cataract surgery is non-inferior to conventional phacoemulsification cataract surgery at 3 months.
- Both surgical methods demonstrate comparable efficacy in vision, patient-reported health, and safety.
- Longer-term clinical and cost-effectiveness data are pending.
