First Experience With Femtosecond Laser–Assisted Cataract Surgery in the Baltic Countries (Presented in Russian)
To investigate the safety and efficacy of the femtosecond laser-assisted cataract surgery and compared it with conventional phacoemulsification cataract extraction surgery.
Femtosecond laser-assisted cataract surgery involved anterior capsulotomy and lens fragmentation based on optical coherence tomography-guided treatment mapping. Conventional cataract surgery involved manual continuous curvilinear capsulorhexis. Prospective cohort study included 25 patients (50 eyes) who underwent conventional cataract surgery and 25 patients (50 eyes) who underwent femtosecond laser-assisted cataract surgery between January and March 2014. Both procedures were completed by standard phacoemulsification and insertion of an intraocular lens. Cataract was combined with the following pathology: glaucoma (19 eyes), lens subluxation and pseudoexfoliative syndrome (2 eyes), myopia of high degree (4 eyes). The following examinations were performed before the surgery: vision acuity check, tonometry, biomicroscopy, A-scan, IOL-master, perimetry, optic nerve OCT, confocal mycroscopy.
Patient demographics were similar between both groups. There was no statistically significant difference in intraoperative complications between femtosecond laser-assisted cataract surgery and conventional surgery.100% of cases treated with the femtosecond laser had a complete capsulotomy. Vacuum time decreased with experience. Effective phacoemulsification time was reduced by 70% in the femtosecond group (P < 0.0001).There were no «bridges» during femtocapsulorhexis, and no posterior capsula ruptures or other complications during phacoemulsification. Before operation VA ranged from pr.certa to 0.5 and average IOP was 20.6 mm Hg. After the surgery the mean VA was 0.80 in both groups. Mean ebdothelial cell loss was 138,8 cell/mm2 in FLACS (p=0,001) and 277,7 cell/mm2 in the phaco group. In 7 cases (cataract combined with far advanced glaucoma) patients used hypotensive medications for IOP compensation.
Femtosecond laser-assisted cataract surgery appears to be as safe as conventional cataract surgery in the short term and results in significantly lower effective phacoemulsification time. Although it may allow for greater efficiency and decreased postoperative complications.