Current Ophthalmology Reports

, Volume 6, Issue 4, pp 245–248 | Cite as

Femtosecond Laser-Assisted Cataract Surgery vs. Phacoemulsification: Overall Safety and the Effect on the Corneal Endothelium

  • Bryan S. LeeEmail author
  • David F. Chang
Cataract (CE Starr and A Brissette, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cataract


Purpose of Review

To summarize current evidence on the safety of cataract surgery with and without the femtosecond laser

Recent Findings

Large studies, including a government-financed randomized controlled trial, have consistently failed to demonstrate any additional safety benefit from femtosecond laser–assisted cataract surgery (FLACS) when compared to manual phaco. Additional high-quality studies, such as the European Society for Cataract and Refractive Surgery EUREQUO FLACS Study, suggest that manual cataract surgery actually has fewer complications. The data on whether FLACS reduces endothelial cell count loss are mixed. Similarly, proof of a significant improvement in refractive outcomes from FLACS has not been demonstrated.


Although individual surgeon preferences for FLACS may continue, current evidence shows that it is at best noninferior to standard manual cataract surgery. Given the additional costs associated with use of FLACS, ophthalmologists discussing this technology with patients should take care not to overstate its potential benefits.


Phacoemulsification Cataract surgery Femtosecond laser Femtosecond laser–assisted cataract surgery 


Compliance with Ethical Standards

Conflict of Interest

David Chang has the following relevant financial interests: Mynosys, Iantech, J&J Vision, RxSight. Bryan Lee reports personal fees from Allergan, personal fees from New World Medical, personal fees from Katena, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Altos Eye PhysiciansLos AltosUSA
  2. 2.Stanford UniversityStanfordUSA
  3. 3.University of California, San FranciscoSan FranciscoUSA

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