Abstract
BackgroundTo evaluate the efficiency and practicality of femtosecond laser assisted cataract surgery (FLACS) in a public teaching hospital setting using a mobile FLACS system compared to conventional phacoemulsification cataract surgery (CPCS).MethodsNinety eyes from 90 patients underwent either FLACS or CPCS (45 in each group). Cataracts were graded using the Lens Opacities Classification System III system. Outcome measures included total surgery duration, femtosecond laser treatment time, vacuum time (VT), total phacoemulsification time (TPT) and total phacoemulsification power (TPP).ResultsNo differences were observed in the preoperative mean cataract grades and co-morbidities. FLACS took longer than CPCS with a mean difference of 5.2 ± 4.5 min (range: 0–18.8 min). The average femtosecond laser treatment time was 4.3 ± 3.4 min (range: 1–15.5 min). The VT was 2.51 ± 0.45 min (range: 1.59–4.10 min). Although not significant, TPT in FLACS showed a trend towards improvement (mean 1.0 ± 0.6 s; range: 0.1–2.4 s) compared to CPCS (mean 1.2 ± 0.6 min; range: 0.5–2.5 min). Whereas, TPP was significantly less in FLACS (mean 17.9 ± 5.0%; range: 5–27%) compared to CPCS (mean 20.3 ± 4.1%; range: 12.0–28.7%)(p = 0.031).ConclusionsThe mobile FLACS system housed in the same operating room increased the surgical duration by 5.2 min. The average VT was 2.51 min, which was lower in comparison to published experience using non-mobile FLACS systems.
Highlights
To evaluate the efficiency and practicality of femtosecond laser assisted cataract surgery (FLACS) in a public teaching hospital setting using a mobile FLACS system compared to conventional phacoemulsification cataract surgery (CPCS)
Unlike other theatre equipment, most FLACS lasers are completely immobile which means patients must be shuttled between rooms to complete surgery which adds time and increases risk of Vasquez-Perez et al BMC Ophthalmology (2018) 18:26 infection and creates an additional liability burden for a hospital in the event that a patient sustains an injury during the transfer [13]
There was no significant difference in the LOCS III grading of the cataracts between the FLACS and CPCS groups
Summary
To evaluate the efficiency and practicality of femtosecond laser assisted cataract surgery (FLACS) in a public teaching hospital setting using a mobile FLACS system compared to conventional phacoemulsification cataract surgery (CPCS). Femtosecond laser assisted cataract surgery (FLACS) has been shown to offer numerous potential advantages including a customized size and centration of capsulorhexis, astigmatic incisions and lens fragmentation of white and brunescent cataracts [1,2,3,4,5,6]. It requires less phacoemulsification power and time thereby diminishing corneal endothelial injury; its superiority over conventional phacoemulsification cataract surgery (CPCS) is still under scientific scrutiny [7,8,9]. Unlike other theatre equipment, most FLACS lasers are completely immobile which means patients must be shuttled between rooms to complete surgery which adds time and increases risk of Vasquez-Perez et al BMC Ophthalmology (2018) 18:26 infection and creates an additional liability burden for a hospital in the event that a patient sustains an injury during the transfer [13]
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