Clinical Ophthalmology (Mar 2021)
The Latest Evidence with Regards to Femtosecond Laser-Assisted Cataract Surgery and Its Use Post 2020
Abstract
Lewis M Levitz,1 H Burkhard Dick,2 Wendell Scott,3 Chris Hodge,1,4,5 Joseph A Reich1 1Vision Eye Institute, Hawthorn East, VIC, Australia; 2University Eye Hospital, Bochum, Germany; 3Mercy Clinic Eye Specialists, Springfield, MO, USA; 4Save Sight Institute, The University of Sydney, Sydney, NSW, Australia; 5Graduate School of Health, University of Technology Sydney, Sydney, NSW, AustraliaCorrespondence: Lewis M LevitzVision Eye Institute, 27 Denmark Hill Road, Hawthorn East, VIC, 3123, AustraliaTel +61 3 98821347Fax +61 3 9882 3312Email [email protected]: Femtosecond laser-assisted cataract surgery (FLACS) was introduced with the hope of making cataract surgery safer and making the refractive result more predictable. It is only in the last four years that level 1 prospective randomised controlled trials (RCT) using current technology have been published. These, along with a meta-analysis of recent studies have shown that there seems to be little long-term visual benefit when using FLACS with monofocal lenses. The promised decrease in ultrasound energy required to remove a cataract has not been consistently demonstrated. There is level one evidence that the rate of posterior capsular rupture is less with FLACS using modern software. The round capsulotomy may be of increasing importance with the uptake of toric, multifocal and extended depth of focus lenses where a predictable capsulotomy size and precise placement of the lens becomes more important.Keywords: femtosecond laser-assisted cataract surgery: conventional cataract surgery, posterior capsular rupture, extended depth of focus intraocular lenses, pseudophakic cystoid macular oedema
