FLACS Reduces Effective Phacoemulsification Time in Cataract Surgery

Femtosecond laser-assisted cataract surgery (FLACS) reduces effective phacoemulsification time (EPT) significantly compared with conventional cataract surgery, according to research published in International Ophthalmology.

Researchers conducted a prospective, nonrandomized, controlled study to determine the efficacy of different fragmentation patterns in FLACS. 

The team used a femtosecond laser to evaluate the ability of FLACS to reduce effective phacoemulsification time and compare a novel “spiderweb” fragmentation pattern with conventional radial slices (pie segment pattern) and conventional cataract surgery without a precut pattern. The primary endpoint was a determination of whether FLACS reduces effective phacoemulsification time vs conventional cataract surgery. 

A total of 845 eyes were included in the study. Of those, 261 (mean age, 69.3±9.4 years) eyes underwent FLACS with the the novel fragmentation pattern, 234 (70.5±9.7 years) eyes underwent FLACS with the pie segment pattern, and 350 (71.3±9.8 years) eyes underwent conventional cataract surgery. 

The investigators found that FLACS reduces effective phacoemulsification time significantly, by 26% using either the novel or pie segment patterns, when compared with conventional cataract surgery (2.46±2.60 s vs 3.34±2.89 seconds; mean difference, – 0.88 seconds; P <.001). 

They report that effective phacoemulsification time as a function of progression of lens opacity is significantly lower with FLACS when the novel spiderweb pattern is used (2.28±2.64 seconds) than with conventional cataract surgery (3.34±2.89 seconds; mean difference, 1.06 second; P <.001) or FLACS with pie segment pattern (2.66±2.54 seconds; mean difference, 0.68 seconds; P =.015). 

“In conclusion, our study, as well as several others, found that FLACS reduces EPT, but this varies depending on the fragmentation pattern used,” according to the researchers.  “This study represents a development toward a more automated procedure for cataract surgery.” 

Limitations of the study included the nonrandomized design, application of the findings to the 1 femtosecond laser platform only, non-objective grading of nuclear opacity according to the Lens Opacities Classification System III (LOCS III) , and no consideration of lens thickness.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.