Transitioning to Femtosecond Laser–Assisted Cataract Surgery: Results
Purpose
Femtosecond laser assisted cataract surgery (FLACS) is becoming the standard of choice for most cataract surgeons. There have been several reports by experienced surgeons reporting on outcomes and complication rates in FLACS. However, for the novice trying to transition from phacoemulsification to FLACS, this change can be very daunting. This is a pilot study to evaluate the difficulties encountered by newer surgeons of FLACS
Methods
Self- administered questionnaire by experienced surgeons who are transitioning from phacoemulsiifcation to FLACS. These surgeons have undergone didactic lectures and wet lab sessions on animal eyes using the Victus laser platform at the Singapore National Eye Centre. These surgeons were also supervised by an experienced FLACS surgeon for the first four cases.
Results
A total of 8 surgeons were interviewed. Average rate of FLACS cases was 0.8%. 6/8 felt that the additional cost to the patient for FLACS was difficult to justify. 5/8 felt there was no additional benefit especially for standard IOLs. 4/8 felt it was logistically too troublesome.
6/8 wanted more published data showing benefits of FLACS.
With regards to problems encountered, 5/8 complained about incompletely cut nuclear fragments. Other problems included incomplete capsulotomy, dissection of the incisions, and removal of adherent soft lens material.
Conclusion
FLACS has a steep learning curve even to the most experienced cataract surgeons. Understanding the problems encountered in virgin FLACS surgeons can help ease the transition and improve outcomes.