Metaanalysis and systematic review of femtosecond laser lens surgery and conventional lens surgery

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS)

Session Date/Time: Sunday 11/09/2016 | 08:00-10:00

Paper Time: 08:00

Venue: Hall C1

First Author: : T.Kohnen GERMANY

Co Author(s): :    L. Mathys   K. Petermann   E. Herrmann   W. Mayer   M. Shajari        

Abstract Details

Purpose:

This systematic review and meta-analysis compares femtosecond laser cataract surgery (FLACS) with conventional cataract surgery (CCS) and reviews prospective and retrospective clinical trials. In 34 included studies there were 6,492 eyes receiving FLACS compared to 6,707 eyes receiving CCS.

Setting:

Department of Ophthalmology, University of Frankfurt, Germany

Methods:

We systematically searched the peer-reviewed literature in Medline (30.04.2015 – 01.03.2016), Cochrane Library (13.05.2015 – 01.03.2016) and Embase (13.07.2015 – 23.11.2015) according to PRISMA guidelines. Only prospective and retrospective trials, which performed FLACS as well as CCS and compared both procedures, were included. The effects were calculated as mean differences or standardized mean differences. A total of 34 studies (29 prospective, 5 retrospective) with a total of 6,492 eyes undergone FLACS and 6,707 eyes undergone CCS were included.

Results:

No significant difference was found in terms of corrected distance visual acuity (CDVA) (2,443eyes, P=0.48), clinically manifested macular edema (1,928eyes, P=0.51), and posterior capsule rupture (6,386eyes, P=0.97). In eyes treated with FLACS uncorrected distance visual acuity (UDVA) (2215eyes, P<0.01) was better, endothelial cell loss was less (1,335eyes; P<0.01), circularity was better (330eyes; P<0.01; risk for anterior capsule rupture higher (4,731eyes; P<0.01), and effective phacoemulsification time less (1,382eyes; P<0.01). In individual studies it was shown that variability of surgically induced astigmatism, lens decentration, tilt and posterior capsule opacification were less in FLACS.

Conclusions:

FLACS has a comparable advantage and disadvantage profile to CCS. However, especially patients with low endothelial cell density, dense cataract or significant amount of corneal astigmatism could benefit more from FLACS.

Financial Disclosure:

NONE