Comparison of Femtosecond Laser–Assisted Cataract Surgery and Conventional Phacoemulsification in White Cataracts
Purpose
To evaluate the role of Femtosecond laser assisted cataract surgery (FLACS) in white cataracts, and to study if FLACS offers any advantage over conventional phacoemulsification in the hands of an experienced surgeon.
Methods
Prospective randomized study of 52 eyes (52 patients) with white cataract undergoing either FLACS (Alcon LenSx Inc.) (group I, n=26) or conventional phacoemulsification (group II, n=26) by an experienced surgeon. Size, shape, centration and continuity of capsulorhexis, cumulative dissipated energy (C.D.E), total ultrasonic time, total aspiration time, IOL implantation and total duration of surgery were compared. Intraoperative complications, if any, were noted. Capsulorhexis diameter, IOL optic coverage by rhexis margins and visual acuity were assessed postoperatively.
Results
In group I, free floating circular capsulotomies were achieved in 58.8% cases; 41.2% required release of microadhesions. Inadequate IOL coverage was observed in 5.9% cases (group I) and 19.4% cases (group II) respectively (p=0.39). C.D.E was comparable (p=0.09); however, group I had prolonged aspiration time (0.012) and total surgical duration(0.018). Mean capsulorhexis diameter was 5.05±0.13 mm in group I and 5.50±0.55 mm in group II (p=0.014). No case of anterior capsular radial tear/extension, posterior capsular rent, nucleus drop or inability to implant IOL was noted in either group. Visual outcomes were comparable. Recruitment ongoing, results to be updated.
Conclusion
FLACS has advantage over conventional phacoemulsification in white cataracts in performing an ideal sized circular capsulotomy. Increased total surgical duration in FLACS is due to longer aspiration times. However, there was no difference in visual outcomes in the early postoperative period.