FLACS vs conventional phacoemulsification by junior cataract surgeons: randomized trial.

Area of Science:

• Ophthalmology
• Surgical Technology
• Medical Devices

Background:

• Cataract surgery is a common procedure to restore vision.
• Femtosecond laser-assisted cataract surgery (FLACS) is an advanced technique compared to conventional phacoemulsification (PE).
• Evaluating surgical techniques in the hands of less experienced surgeons is crucial for patient outcomes.

Purpose of the Study:

• To compare the intraoperative performance and postoperative outcomes of FLACS versus PE.
• To assess the safety and efficacy of FLACS when performed by junior surgeons.
• To provide data on the learning curve and benefits of FLACS in standard cataract surgery.

Main Methods:

• A prospective, single-masked randomized controlled trial was conducted with 320 patients.
• Patients were randomized to undergo either FLACS or conventional PE.
• Key metrics included intraoperative cumulative dissipated energy (CDE), fluid usage, central corneal thickness (CCT), corneal clarity, anterior chamber inflammation, endothelial cell density (ECD) change, and corrected distance visual acuity (CDVA).

Main Results:

• FLACS group showed significantly lower CDE and fluid usage compared to PE.
• The FLACS group exhibited a significantly lower increase in CCT on postoperative day 1 and at 1 week.
• Early corneal clarity was significantly better in the FLACS group, with less endothelial cell loss at 6 months postoperatively.

Conclusions:

• Femtosecond laser-assisted cataract surgery (FLACS) demonstrates superior intraoperative efficiency and improved early postoperative outcomes compared to conventional phacoemulsification (PE) when performed by junior surgeons.
• FLACS leads to reduced corneal edema and better preservation of endothelial cells.
• These findings support the adoption of FLACS by surgeons early in their practice for standard cataract procedures.