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Interim results of a randomised controlled trial comparing conventional phacoemulsification surgery to femtosecond laser-assisted cataract surgery: the first 181 patients

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Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS) I

Session Date/Time: Sunday 08/10/2017 | 08:00-10:00

Paper Time: 08:06

Venue: Room 3.6

First Author: : H.Roberts UK

Co Author(s): :    V. Wagh   D. O'Sullivan   S. Heemraz   D. Detesan   D. O'Brart        

Abstract Details


To compare clinical results of the first 181 out of 400 patients enrolled in a randomised controlled trial comparing conventional phacoemulsification surgery (CPS) to femtosecond laser assisted cataract surgery (FLACS).


St Thomas’ Hospital, London, UK


Patients undergoing cataract surgery were randomised to receive either CPS or FLACS. FLACS was performed with a LenSx (Alcon Inc). Surgery was performed by 3 surgeons all of whom were experienced with FLACS. Exclusion criteria were inability to lie flat, need for general anaesthetic, insufficient English or lacking sufficient capacity to consent. Patients were followed up 3 weeks after surgery. Visual acuity (VA), refraction, intraocular pressure (IOP), cumulative dissipated energy (CDE) central corneal thickness (CCT), endothelial cell loss (ECL), central macular thickness (CMT) and rates of intraoperative and postoperative complications were recorded.


88 patients were randomised to CPS and 93 to FLACS, of whom 8 did not receive FLACS(8.6%). Average CDE was 10.7±8.8 for CPS and 9.1±6.6 for FLACS(p=0.17). Unaided visual acuity was 6/5 or better in 14.7% for CPS and 12% for FLACS, 6/6 or better in 41.3%and 37.3%. Intraoperative complications occurred in 6.8%of CPS (Dropped nucleus1.1%, vitreous loss1.1%, suprachoroidal haemorrhage1.1%, zonular dialysis1.1%, anterior capsular tear1.1%, iris trauma3.3%) and 3.3% of FLACS (anterior capsular tear1.1%, Descemets tear1.1%, iris trauma1.1%). ECL was 11.0%±10.9 for CPS and 7.37%±13.2 for FLACS(p=0.11).


At three weeks after surgery no significant differences were observed between FLACS and CPS in terms of VA, CDE or ECL. CPS had a higher rate of intraoperative complications.

Financial Disclosure:

research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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