The Latest Evidence with Regards to Femtosecond Laser-Assisted Cataract Surgery and Its Use Post 2020

Figures & data

Table 1 Significant Difference Between FLACS and Conventional Cataract Surgery Variables in Level 1 RCTs or Meta-Analysis Literature 2016–2020

First Author	Year	Cohort	Visual Acuity At 3 Months	Corneal Recovery at 1 Month	Ultrasound Power	Cystoid Macular Edema
Roberts et al^Citation6	2019	Multiple surgeons RCT	No difference	No difference	No difference	–
Day et al^Citation7	2020	Multiple surgeons RCT	No difference	–	–	–
Kolb et al^Citation8	2020	Meta-analysis	No difference	-	Yes (FLACS advantage)	None
Schweitzer et al^Citation9	2020 Recruitment prior to 2016	Multiple surgeons RCT	No difference	None	None

Table 2 Incidence of Posterior Capsular Complications in FLACS Literature 2016–2020

First Author	Year	Cohort	Evidence Level	FLACS (%)	Manual (%)	Cases (FLACS vs Manual)
Roberts et al^Citation6	2019	Multiple surgeons	1	0.0%	3.0%	0/200 vs 6/200*
Day et al^Citation7	2020	Multiple surgeons	1	0.0%	0.5%	0/392 vs 2/393
Scott et al^Citation34	2016	Multiple surgeons	2	0.65%	1.17%	22/3367 vs 44/3775*
Brunin et al^Citation36	2017	Registrars	3	0.00%	3.00%	0/76 vs 3/101
Hou et al^Citation37	2015	Registrars	3	0.00%	3.00%	0/68 vs 4/128
Wang et al^Citation38	2018	Multiple surgeons (post vitrectomy eyes)	3	0.00%	12.0%	0/25 vs 3/25

Note: *Statistically significant.

Roberts HW, Wagh VK, Sullivan DL, et al. A randomized controlled trial comparing femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery. J Cataract Refract Surg. 2019;45(1):11–20. doi:10.1016/j.jcrs.2018.08.033

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Day AC, Burr JM, Bennett K, et al. Femtosecond laser-assisted cataract surgery versus phacoemulsification cataract surgery (FACT): a Randomized Noninferiority Trial. Ophthalmology. 2020;127(8):1012–1019. doi:10.1016/j.ophtha.2020.02.028

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Kolb CM, Shajari M, Mathys L, et al. Comparison of femtosecond laser–assisted cataract surgery and conventional cataract surgery: a meta-analysis and systematic review. J Cataract Refract Surg. 2020;46(8):1075–1085. doi:10.1097/j.jcrs.0000000000000228

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Schweitzer C, Brezin A, Cochener B, et al. Femtosecond laser-assisted versus phacoemulsification cataract surgery (FEMCAT): a multicentre participant-masked randomised superiority and cost-effectiveness trial. Lancet. 2020;395(10219):212–224. doi:10.1016/S0140-6736(19)32481-X

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Scott WJ, Tauber S, Gessler JA, et al. Comparison of vitreous loss rates between manual phacoemulsification and femtosecond laser–assisted cataract surgery. J Cataract Refract Surg. 2016;42(7):1003–1008. doi:10.1016/j.jcrs.2016.04.027

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Brunin G, Khan K, Biggerstaff KS, et al. Outcomes of femtosecond laser-assisted cataract surgery performed by surgeons-in-training. Graefes Arch Clin Exp Ophthalmol. 2017;255(4):805–809. doi:10.1007/s00417-016-3581-x

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Hou JH, Prickett AL, Cortina MS, et al. Safety of femtosecond laser-assisted cataract surgery performed by surgeons in training. J Refract Surg. 2015;31(1):69–70. doi:10.3928/1081597X-20141218-07

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Wang EF, Worsley A, Polkinghorne PJ. Comparative study of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in vitrectomized eyes. Clin Exp Ophthalmol. 2018;46(6):624–629. doi:10.1111/ceo.13133

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