Posterior Capsular Rupture Rates In Femtosecond Laser Assisted Vs Manual Cataract Surgery: Systematic Review And Meta-Analysis

Posterior capsular rupture (PCR) is one of the most significant intraoperative complications in cataract surgery, associated with increased risk of vitreous loss, retinal detachment, and postoperative visual morbidity. With the increasing adoption of femtosecond laser-assisted cataract surgery (FLACS), comparative data on PCR rates versus conventional manual phacoemulsification remain inconsistent. This study aims to systematically review the literature and perform a meta-analysis to quantify and compare PCR rates in FLACS and manual cataract surgery, providing evidence to inform surgical decision-making and risk counseling.

Literature-based study focused on contemporary cataract surgery practice and patient safety outcomes, independent of clinical data collection.

This systematic review and meta-analysis will follow PRISMA 2020 guidelines. PubMed, Cochrane Library, and Web of Science will be searched for studies comparing femtosecond laser-assisted cataract surgery (FLACS) and manual phacoemulsification. Using the PICO framework, adults undergoing cataract surgery (P) treated with FLACS (I) versus manual phaco (C) will be assessed for posterior capsular rupture (O) in comparative studies (S). Two reviewers will independently screen, extract data, assess risk of bias (ROBINS-I/RoB 2), and perform random-effects meta-analysis with I² assessment.

The Review process is underway and will be completed before the congress and the results will be discussed during the presentation.

Posterior capsular rupture remains a critical complication in cataract surgery, with significant implications for surgical outcomes and patient safety. Systematic synthesis of the available literature will provide robust quantitative estimates of PCR risk, facilitating evidence-based decision-making, risk counseling, and optimization of surgical technique in contemporary cataract practice.