Femtosecond laser-assisted cataract surgery (FLACS) vs routine micro-incision cataract surgery (MICS) for emulsifying brown cataracts in Indian eyes

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS)

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

Paper Time: 08:48

Venue: Hall C1

First Author: : R.Chaudhuri INDIA

Co Author(s): :    N. Shroff   A. Koul   R. Dutta   K. Priya           

Abstract Details

Purpose:

To evaluate the safety profile, effectiveness and visual outcome of femtosecond laser-assisted cataract surgery (FLACS) versus routine micro-incision cataract surgery (MICS) in brown cataracts.

Setting:

Cataract & Intraocular Lens Implantation Service, Shroff Eye Centre, A-9 Kailash Colony, New Delhi, India.

Methods:

60 eyes with nuclear sclerosis grade 3 and 4, endothelial cell density > 1800/mm2, with no other anterior or posterior segment pathology underwent cataract surgery by FLACS using the LenSx (30 eyes) and MICS (30 eyes). Phacoemulsification was performed with the Centurion System in all eyes. Intra-operative parameters studied were Cumulative Dissipated Energy (CDE), volume of irrigating fluid, any intra-operative complications. All eyes were examined postoperatively at day-1, day-7, and day-30 for central corneal thickness (CCT), Best corrected visual acuity (BCVA), residual refractive error on day-30. Endothelial cell density (ECD) with specular biomicroscopy was done at day-30.

Results:

Mean CDE was 11.87±5.43 (FLACS) and 17.16±12.62 (MICS) (p=.041). The mean volume of irrigating fluid was 81±19.89 mL (FLACS) and 107±29.04 ml (MICS) (p< .001). LogMAR BCVA on day-1 & 7 was 0.14±0.11 and 0.09±0.13 in the FLACS group, and 0.32±0.13 and 0.19±0.14 in the MICS group respectively (p<.05). UCVA on day-30 was 0.06±0.10 (FLACS) and 0.18±0.09 (MICS) (p<.001). Percentage increase in corneal thickness on days 1 and 7 was 5.38±1.29% and 2.89±1.48% in the FLACS group and 6.75±2.23% and 4.29±1.65% in the MICS group respectively (p<.05). Percentage loss of endothelial cells was 10.72±4.33% (FLACS) 17.27±3.75% (MICS) (p<.001).

Conclusions:

Although both techniques are comparable in terms of best-corrected vision at 30 days, FLACS showed significantly better uncorrected vision with a much more predictable refractive outcome at 30 days, due to better effective lens position (ELP). FLACS also offers an edge over MICS with respect to earlier postoperative rehabilitation, and significantly less endothelial cell loss owing to lesser energy delivered in the eye.

Financial Disclosure:

NONE