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Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Authors Levitz L, Reich J, Hodge C

Received 4 May 2018

Accepted for publication 13 July 2018

Published 6 September 2018 Volume 2018:12 Pages 1701—1706

DOI https://doi.org/10.2147/OPTH.S173089

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser


Lewis Levitz,1 Joseph Reich,1 Chris Hodge1,2

1Vision Eye Institute Camberwell, Hawthorn East, VIC, Australia; 2Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia

Purpose: The aim of the study was to determine whether femtosecond-assisted laser cataract surgery (FLACS) reduces the posterior capsular complication (PCC) rate compared to manual cataract surgery when performed by an experienced surgeon.
Patients and methods: We reviewed 2,021 consecutive FLACS procedures between 1 June 2012 and 30 August 2017. All cases of posterior capsular rupture (PCR) with or without vitreous prolapse or zonular dialysis (ZD) that prevented an in-the-bag placement of the intraocular lens were included. Risk factors were noted and outcomes documented.
Results: Six eyes of 2,021 (0.3%) who underwent FLACS had either a PCR or ZD. One eye (0.25%) of 403 eyes that had manual cataract surgery had a PCR. There was no significant difference in outcomes. Risk factors included advanced age, dense nuclei, pseudoexfoliation and small pupil. Only a single case in the FLACS series may have been directly attributed to the FLACS procedure.
Conclusion: This study provides evidence that there is no significant difference in the PCC rate between FLACS and manual cataract surgery in the hand of an experienced surgeon who performs >350 cases annually. This low rate of complications may be achieved by less experienced surgeons adopting FLACS.

Keywords:
cataract surgery, phacoemulsification complications, femtosecond laser-assisted cataract surgery, safety, posterior capsule rupture, zonular dehiscence

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