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Safety and efficacy of femtosecond cataract surgery compared to conventional phacoemulsification
Poster Details
First Author: M.Crespo-Bordonada SPAIN
Co Author(s): P. Taña E. Artiaga J. Muñoz M. Camiña
Abstract Details
Purpose:
To evaluate the safety and efficacy of cataract surgery performed with a femtosecond laser platform with liquid optics interface compared to the manual technique.
Setting:
Oftalvist Ophthalmology Clinic, Alicante, Spain. Oftalvist Group.
Methods:
A prospective study was performed in 165 patients with a mean age of 66.43 ± 10.10 years who underwent femtosecond laser cataract surgery (study group) and 155 patients with a mean age of 65.49 ± 10.09 years who underwent manual phacoemulsification (control group). All procedures were carried out by the same surgeon. All patients were treated according to the same surgical protocol, except that in 115 patients, the incisions were made with femtosecond laser and in 50, they were performed manually. Capsulorhexis diameter was 5 mm, with a lens-softening pattern of 7 mm, carried out by quadrants with 500 µm grids in some cases and 300 µm in others. The study was performed in accordance with the guidelines and principles of the Declaration of Helsinki. All subjects were over 18 years of age and signed informed consent. Residual refractive error, both spherical equivalent (SE) and induced astigmatism (SIA), total phacoemulsification time, dissipated energy, fluid flow (in terms of volume of balanced saline solution used), percentage loss of corneal endothelial cells and the incidence of post-surgical complications were assessed.
Results:
No statistically significant differences were found in the spherical equivalent in the group undergoing femtosecond laser surgery compared to those treated with the manual technique. However SIA values were significantly lower in the study group compared to the control group (p < 0.001). Both the time and the energy used during phacoemulsification were significantly less in the femtosecond laser group compared to the manual technique (p < 0.001), and a greater volume of balanced saline solution was not required. Regarding the endothelial cell count, patients treated with the manual technique had a 7.65% cell loss, while in the femtosecond laser group, cell loss was 6.10%. This difference was not statistically significant.With regard to the safety of the femtosecond laser technique, all cases were completed with clean capsulotomies, and there were no complications in the anterior capsule or posterior dislocations. The laser incisions had to be completed manually in only 2.5% of the principal incisions and in 4% of the secondary incisions.
Conclusions:
Femtosecond laser-guided cataract surgery has been shown to be safe and effective, with less induced astigmatism compared with the manual technique and no clinically significant complications. FINANCIAL INTEREST: NONE