Femtosecond Laser Versus Conventional Cataract Surgery
The adoption of femtosecond laser-assisted cataract surgery (FLACS) has remained relatively flat over the past few years. Despite many theoretical benefits, peer-reviewed studies to show superiority compared with conventional cataract surgery are sparse.
Lundström and colleagues[1] evaluated 3379 consecutive FLACS cases. The study participants were all experienced surgeons, removing the confounding factor of a learning curve from their results.
Data were segmented by preoperative corrected distance visual acuity (CDVA). Of note, they found that patients with good preoperative CDVA (Snellen 6/3.8 to 6/6) had fewer complications and better visual and refractive outcomes, whereas those with poor preoperative CDVA (worse than Snellen 6/24) had more complications and poorer visual and refractive outcomes.
Overall, they concluded that FLACS results were favorable in comparison to conventional cataract surgery. There was a correlation of outcomes depending on preoperative CDVA, but outcomes were good among the entire cohort overall.
Viewpoint
The study did have a few shortcomings.
The authors did not report on astigmatic outcomes, and the population was skewed to those who were younger (mean age, 64 years) with no ocular comorbidities. This makes it a little difficult to compare the outcome with many of our more common older patients.
