Femtosecond laser-assisted cataract surgery in a public hospital: a single femtosecond laser platform for three different operation rooms

Session Details

Session Title: Presented Poster Session: FLACS

Venue: Poster Village: Pod 1

First Author: : C.Pérez Casaseca SPAIN

Co Author(s): :    M. Rodriguez Calvo de Mora   G. Fernandez-Baca Vaca   E. Espejo de los Riscos                 

Abstract Details

Purpose:

To describe our experience with LenSx (Alcon®) femto-second laser (Fs) platform used for femto-second laser assisted cataract surgery (FLACS) in a public setting. High cataract volume was performed daily: 21 cataracts per session, 7 per operation room (OR). Population showed specific characteristics, such as advanced age, hard cataracts and multiple concomitant ocular and systemic diseases. Each surgeon had performed previously 60 FLACS using the Fs technology.

Setting:

Ophthalmology department of a tertiary referral Spanish public hospital.

Methods:

Retrospective analysis of consecutive cases. We performed 59 FLACS in three surgical sessions. The whole range of patients of our public setting were eligible, only excluding patients with severe miosis, dense corneal opacities and those requiring general anesthesia/sedation. One surgeon performed all the Femtosecond laser (Fs) procedures in one OR whereas the rest of the surgeries were performed by three different surgeons in three different ORs. Age, gender, laterality, concomitant diseases, pre and postoperative best corrected visual acuity (BCVA), pre and postoperative intraocular pressure, type of cataract, intraocular lens power, surgical roll-over times and intra and postoperative complications were analyzed.

Results:

Patients´ mean age was 71.6 ± 8.9, 59.7% were women and 40.3% were male. Preoperative BCVA was lower than 0.4 decimal scale (0.4logMAR) in 98.3% of the patients. Time elapsed from the arrival to the Fs room was 38 ± 21 minutes. Time from Fs room to the OR was 6 ± 7 minutes. Fs and cataract surgery procedure time was 1 ± 1 minute and 11 ± 2 minutes, respectively. Total time from the patient arrival to his departure was 72 ± 20 minutes. Postoperative BCVA was ≥ 0.8 (≥0.10 LogMar) in 55.9% of patients.

Conclusions:

In our setting, cataract surgery is only eligible when BCVA is lower than 0.4 decimal scale (0.4logMAR), except for very specific cases. Besides, our patients have typically advanced age and numerous ocular and systemic comorbidities, therefore cataracts tend to be mature and full collaboration to perform the Fs was not advanced. However, we found that with proper surgical planning, team’s motivation and workflow optimization, satisfactory outcomes within an efficient surgical time can be achieved. In conclusion, is feasible to perform high volume of FLACS with the LenSx platform (Alcon®) even in the setting of a crowded public ophthalmology department.

Financial Disclosure:

None