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Real-world comparison of femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: a retrospective cohort study from an outpatient ophthalmology clinic in France

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Session Details

Session Title: Presented Poster Session: FLACS & Others

Venue: Poster Village: Pod 1

First Author: : C.Bouchet FRANCE

Co Author(s): :    P. Crozafon   M. Dhariwal   M. Zignani   F. Ender   R. Griner   S. Foster

Abstract Details


The standard of care for cataract surgery, phacoemulsification cataract surgery (PCS), requires manual incisions, capsulotomy and lens phacoemulsification. Femtosecond laser technologies allow for greater precision during corneal incisions, capsulotomy and lens pre-fragmentation. As femtosecond laser-assisted cataract surgeries (FLACS) gain popularity more data becomes available to assess treatment outcomes of patients in real-world settings. The primary objective is to assess the benefit of adopting FLACS into routine practice by demonstrating that the use of FLACS reduces the cumulative dissipated energy (CDE), required during surgery. Secondary objectives include investigation into refractive outcomes, IOL positioning, corneal edema and early posterior capsule opacification complications.


A retrospective analysis comparing FLACS (LenSx Laser System) and PCS procedures using anonymised patient-level data from a single French clinic. Procedures were performed in a real-world setting by the same clinician using the same IOL platform, uniquely allowing the comparison of two techniques in an almost identical setting.


The study population was defined as all PCS and FLACS performed at the clinic during the period January 2011 to March 2016, totalling 1,347 procedures. Data was sourced from the clinic’s electronic medical records and contained information on consultations, surgery details, post-surgery outcomes and complications. The primary objective was to compare mean CDE for the surgery types using linear regression to adjust for lens opacification grading, age, gender, and other baseline demographic and clinical covariates. Surgery types were compared for additional objectives, with binary outcomes, using logistic regression.


The study population includes a total of 1,347 eyes that underwent cataracts surgery, 536 of which were FLACS and 811 that were PCS. Mean CDE for FLACS was 6.33 compared to 14.21 for PCS (adjusted difference [95% CI]: 7.89 [6.90; 8.88]; P<0.001).


In real-world studies using retrospective data to assess comparative outcomes, variations in patient flow and different pre-op and post-op protocols can impair the ability to assess comparative outcomes of different surgical procedures. This study has aimed to provide a controlled real-world setting for a retrospective study through the use of data from a single clinic with a single surgeon. The data shows that procedures using the LenSx Laser System (FLACS) required less CDE than PCS procedures.

Financial Disclosure:

is employed by a for-profit company with an interest in the subject of the presentation, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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