Femtosecond Laser-Assisted Cataract Surgery vs. Phacoemulsification: Overall Safety and the Effect on the Corneal Endothelium
Purpose of Review
To summarize current evidence on the safety of cataract surgery with and without the femtosecond laser
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.
KeywordsPhacoemulsification 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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