Femtosecond cataract surgery: A review of current literature and the experience from an initial installation

Diagnostic imaging versus surgical procedure: intra- and postoperative OCT evaluation of sutureless scleral-fixated intraocular lens implantation and possible related complications

Because the popularity of corneal refractive surgery has been increasing throughout the last 25 years, many authors have thought to apply optical coherence tomography (OCT) to the anterior segment (AS-OCT); by revising the instrumentation needed and slightly improve the technique, it has become an element of vital importance in order to ensure a complete and exhaustive pre- and postsurgical evaluation. Many applications of OCT have been recently developed—mostly in cataract surgery due to the increasing numbers—such as chamber biometry, which is used in a preoperative stage to determine the details of IOL implantation, and lens evaluation. The aim of this review is to assess the applications of anterior segment OCT in dislocated IOL and/or capsular bag exchange surgery with scleral sutureless fixated intraocular lens and monitoring of possible postoperative complications.

Update and clinical utility of the LenSx femtosecond laser in cataract surgery

The introduction of femtosecond lasers to cataract surgery has been the major disruptive technology introduced into ophthalmic surgery in the last decade. Femtosecond laser cataract surgery (FLACS) integrates high-resolution anterior segment imaging with a femtosecond laser allowing key steps of cataract surgery to be performed with computer-guided laser accuracy, precision, and reproducibility. Since the introduction of FLACS, there have been significant advances in laser software and hardware as well as surgeon experience, with over 250 articles published in the peer-reviewed literature. This review examines the published evidence relating to the LenSx platform and discusses surgical techniques, indications, safety, and clinical results.

Comparative outcomes of femtosecond laser-assisted cataract surgery and manual phacoemusification: a six-month follow-up

BACKGROUND

To explore efficacy and safety outcomes in patients undergoing femtosecond laser-assisted cataract surgery (FLACS) versus manual phacoemulsification cataract surgery (PCS).

DESIGN

Prospective consecutive nonrandomized comparative cohort study.

PARTICIPANTS

A total of 124 eyes from 106 patients (70 in FLACS and 54 in PCS).

METHODS

Comparison of FLACS with PCS over 6 months.

MAIN OUTCOME MEASURES

Macular central subfield thickness (CST), cube volume (CV), cube average thickness (CAT), endothelial cell density (ECD), central corneal thickness (CCT) and photon count value (PCV).

RESULTS

CST, CV and CAT increased postoperatively, which did not return to preoperative levels by 6 months. The values were similar between groups throughout the follow-up, and comparison of changes from baseline also showed no significant difference. Preoperative ECD showed significant difference, which decreased postoperatively and remained stable during follow-up, being lowest at 1 month. FLACS had greater endothelial cell loss than PCS, which was not significant. CCT in both groups increased, reaching maximum on day one and tended to decrease thereafter. No significant differences were found regarding postoperative values and the mean increase. In both groups, mean PCV increased from preoperatively to day one, week one and month one. Flare values in FLACS were lower than PCS, reaching statistical significance at 6 months (P = 0.001). However, the differences in changes of PCV were not significantly different at any visit.

CONCLUSIONS

Both FLACS and PCS achieved similar safety and efficacy outcomes for performing cataract surgery. Flare values in eyes with FLACS were lower than those with PCS at 6 months postoperatively.

Femtosecond laser-assisted cataract surgery--current status and future directions

Femtosecond laser-assisted cataract surgery (FLACS) putatively offers several advantages over conventional phacoemulsification. We review the current status of FLACS and discuss the evolution of femtosecond lasers in cataract surgery and the currently available femtosecond laser platforms. We summarize the outcomes of FLACS for corneal wound creation, limbal relaxing incisions, capsulotomy, and lens fragmentation. We discuss surgical planning, preoperative considerations, clinical experiences including the learning curve and postoperative outcomes with FLACS, and also the cost effectiveness of FLACS. We present the intraoperative complications and management of challenging cases where FLACS offers an advantage and also speculate on the future directions with FLACS. Further advancements in laser technology to refine its efficacy, advancement in intraocular lens design to harness the potential benefits of FLACS, and a reduction in cost are needed to establish a clear superiority over conventional phacoemulsification.