Laser cataract surgery favored over phaco for reducing ultrasonic energy use
Consortium finds procedure well tolerated, safe; does not compromise surgical efficiency
Take-home message: The Laser Cataract Consortium, comprising five experienced laser cataract surgeons, undertook a study incorporating rigorous collection of data from 7,200 eyes undergoing cataract surgery.
Bowie, MD—Femtosecond laser-assisted cataract surgery is at least as safe and efficient as standard phacoemulsification, but has a clear benefit for significantly reducing ultrasonic energy use, said Jonathan D. Solomon, MD.
Such are the results from a large, prospective multicenter study including more than 7,200 eyes. The study, undertaken by the Laser Cataract Consortium, was conducted at four clinical sites and involved five surgeons (Dr. Solomon, Neel Desai, MD, Paul Kang, MD, Robert Weinstock, MD, and William Wiley, MD) who were experienced in laser cataract surgery, each already having performed more than 100 cases.
All four cataract surgery femtosecond laser platforms available in the United States (Catalys, Abbott Medical Optics; LENSAR Laser System, LENSAR; LenSx, Alcon Laboratories; Victus, Bausch + Lomb) were represented across the different centers, as were three different phacoemulsification systems (Infiniti Vision System with OZil, Alcon; Whitestar Signature with Ellips FX, Abbott Medical Optics; Stellaris, Bausch + Lomb).
In total, the non-randomized study included 2,231 eyes operated on with laser cataract surgery and 5,000 eyes that underwent traditional phacoemulsification using the surgeon’s preferred method.
Recorded data included patient-reported pain with the laser procedure, phacometrics (total ultrasound energy or time and infusion volume), and complications, as well as surgeon-graded ease of docking, subconjunctival hemorrhage/chemosis, capsulotomy completeness, wound opening ease, and incision integrity with laser cataract surgery. Standardized definitions and scales were used for data collection.
“Previous studies have evaluated the ease, surgical efficiency, safety, and impact on phacodynamics and fluidics of laser cataract surgery,” said Dr. Solomon, director of refractive/cataract surgery, Solomon Eye Physicians and Surgeons, and research director, Bowie Vision Institute, Bowie, MD. “While those studies include several very large series, they were all from a single center using only a single laser system.”
Significance of findings
The consortium study is prospective, uses a standardized data collection form, comprises the largest population of patients to date, represents a full range of cataract densities, and is the first to include multiple surgeons evaluating multiple platforms using a standardized approach to data collection, he noted.