Outcomes of femtosecond laser-assisted cataract surgery performed by surgeons-in-training.

Abstract

To compare intraoperative factors and post-operative outcomes of femtosecond laser-assisted cataract surgery (FLACS) and manual cataract surgery performed by resident surgeons. All cases of FLACS performed by resident surgeons during the 2013-2014 academic year were compared to a control group of manual cataract surgery cases with regards to pre-operative patient data, operative complications, cumulative dissipated energy (CDE), postoperative corrected distance visual acuity (CDVA), refractive prediction error (RPE), and corneal edema. There were no significant preoperative differences in the FLACS (n = 57) and manual (n = 68) groups. Operative complication rates were similar in cases with sufficient data and follow-up with a higher rate of posterior capsule tear in the manual group. CDE (percent-seconds) was lower in the FLACS group (FLACS: 14.5 ± 7.5; manual: 21.6 ± 11.5; p < 0.01). CDVA (LogMAR) was comparable at 1month postoperatively (FLACS: 0.004 ± 0.08; manual: 0.024 ± 0.11; p = 0.24) and 1year postoperatively (FLACS: 0.013 ± 0.06; manual: 0.032 ± 0.09; p = 0.37). No difference in RPE was found at 1month postoperatively (FLACS: 0.38 ± 0.24 D; manual: 0.41 ± 0.49 D; p = 0.66) and 1year postoperatively (FLACS: 0.49 ± 0.63 D; manual: 0.34 ± 0.26 D; p = 0.31). Femtosecond laser-assisted cataract surgery is safe and effective compared to manual cataract surgery when performed by resident surgeons. Both 1-month and 1-year outcomes show no difference in refractive predictive error in FLACS compared to manual cataract surgery in surgeons in training.