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Femtosecond laser-assisted cataract surgery in a public hospital: demographic characteristics, concomitant diseases and surgical complications

Poster Details

First Author: C.Pérez Casaseca SPAIN

Co Author(s):    G. Fernandez-Baca Vaca   J. Coin Ruiz   J. Villalvilla Castillo              

Abstract Details

Purpose:

To describe the specific characteristics of the target population in our public setting, such as advanced age, hard cataracts and multiple concomitant ocular and systemic diseases and the complications when performing femto-second laser assisted cataract surgery (FLACS) with LenSx (Alcon�Â�®) femto-second laser (Fs) platform.

Setting:

Ophthalmology department of a tertiary referral Spanish public hospital.

Methods:

Retrospective analysis of consecutive cases. We performed 59 FLACS in three surgical sessions. The whole range of patients of our public setting were eligible, only excluding patients with severe miosis, dense corneal opacities and those requiring general anesthesia. One surgeon performed all the Femtosecond laser (Fs) procedures in one OR whereas the rest of the surgeries were performed by three different surgeons in three different ORs. Age, gender, laterality, concomitant diseases, pre and postoperative best corrected visual acuity (BCVA), pre and postoperative intraocular pressure (IOP), type of cataract, intraocular lens power and intra and postoperative complications were analyzed.

Results:

Patients mean age was 71.6 �Â�± 8.9, 59.7% were women. Preoperative BCVA was �ï�‚�£ 0.4 logMAR in 98.3% of eyes, whereas postoperatively was �â�‰�¥0.10 logMar in 55.9% (p<0.05). Frequent concomitant ocular diseases were: narrow anterior chamber (AC) (7 eyes), severe ametropia (7), glaucoma (5), choroidal membrane (5) and amblyopia (3). Frequent concomitant systemic diseases were: high blood pressure (23 patients), diabetes mellitus (16), hypercholesterolemia (13), cardiac diseases, benign prostatic hyperplasia (5) and cancer (5). Intraoperative complications were: 4 incomplete capsulorhexis, 3 post-Fs miosis and 3 posterior capsule breaks. Postoperatively, cortical fragments in the AC were found in 3 patients.

Conclusions:

In our public setting, cataract surgery is only eligible when BCVA is lower than 0.4logMAR, except for very specific cases. Besides, our patients have typically advanced age and numerous ocular and systemic comorbidities. Cataracts tend to be mature, full collaboration to perform the Fs is not always advanced and the postoperative results may not be optimal due to the concomitant diseases. However, we found that, even with such a specific target population, good postoperative results can be achieved with FLACS with an acceptable range of complications.

Financial Disclosure:

NONE

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