Visual and refractive outcomes of femtosecond laser cataract surgery for different cataract severity grades in a randomised controlled trial: the FEMCAT study

Session Details

Session Title: Evolution in FLACS & Phaco Technology

Session Date/Time: Sunday 23/09/2018 | 08:00-09:45

Paper Time: 08:00

Venue: Room A3, Podium 2

First Author: : C.Schweitzer FRANCE

Co Author(s): :    N. Hayes   A. Brezin   B. Cochener   P. Denis   P. Pisella   A. Benard     

Abstract Details

Purpose:

To compare clinical and visual outcomes between femtosecond laser assisted cataract surgery (FCS) and phacoemulsification cataract surgery (PCS) for different cataract severity grade in the randomized and controlled FEMCAT (impact Médico-Economique de la chirurgie de la CAtaracte au laser Femtoseconde) study.

Setting:

University hospital of Bordeaux (France), and Lyon, Tours, Paris and Brest University Hospitals (France)

Methods:

A web-based and centralized randomization was performed with a stratification by centers. Patients and examiners were masked to randomization arm. Cataract severity was assessed preoperatively using the lens Opacities Classification System version 3 (LOCSIII, Chylac, USA) grading scale. Visual and anatomical outcomes were measured at 1 month, 3 months and 12 months postoperatively. Success was defined at 3 months as a combination of 4 outcome measures: absence of severe perioperative or postoperative complications within the 3 months period, a best corrected visual acuity of 0.0 LogMAR, an absolute refractive error ≤ 0.75 Diopters and no change in postoperative corneal astigmatism.

Results:

1476 eyes of 907 patients were randomized (736 in the FCS group and 740 in the PCS group). The mean age was 72.3+/-8.6 years, mean and median nuclear opacity (NO) grades were 3.3+/-1.2 and 3.1 (min:0.0-first quartile:2.6- third quartile: 4.0-max:6.9) respectively without significant differences between the two groups. For NO grade ≤ 3.1, the success rate was 59.9% in the FCS and 56.0% in the PCS group (Odds ratio (OR): 1.12 (95%Confidence Interval (CI): 0.74;1.7), p=0.577). For NO grade >3.1, the success rate was 46.8% in the FCS group and 53.1% in the PCS group (OR: 0.77 (95%CI: 0.52;1.14), p=0.187).

Conclusions:

Femtosecond laser and phacoemulsification cataract surgery techniques exhibited comparable success rates in a large population sample. We did not observe any significant difference of success rate between the 2 groups for either harder or softer cataract severity grades. Further explorations are still needed to evaluate the clinical benefit of FCS over PCS for patients.

Financial Disclosure:

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