Official ESCRS | European Society of Cataract & Refractive Surgeons
Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


escrs app advert

Visual and refractive outcomes of femtosecond laser cataract surgery for different cataract severity grades in a randomised controlled trial: the FEMCAT study

Search Title by author or title

Session Details

Session Title: Evolution in FLACS & Phaco Technology

Session Date/Time: Sunday 23/09/2018 | 08:00-09:45

Paper Time: 08:00

Venue: Room A3, Podium 2

First Author: : C.Schweitzer FRANCE

Co Author(s): :    N. Hayes   A. Brezin   B. Cochener   P. Denis   P. Pisella   A. Benard     

Abstract Details


To compare clinical and visual outcomes between femtosecond laser assisted cataract surgery (FCS) and phacoemulsification cataract surgery (PCS) for different cataract severity grade in the randomized and controlled FEMCAT (impact Médico-Economique de la chirurgie de la CAtaracte au laser Femtoseconde) study.


University hospital of Bordeaux (France), and Lyon, Tours, Paris and Brest University Hospitals (France)


A web-based and centralized randomization was performed with a stratification by centers. Patients and examiners were masked to randomization arm. Cataract severity was assessed preoperatively using the lens Opacities Classification System version 3 (LOCSIII, Chylac, USA) grading scale. Visual and anatomical outcomes were measured at 1 month, 3 months and 12 months postoperatively. Success was defined at 3 months as a combination of 4 outcome measures: absence of severe perioperative or postoperative complications within the 3 months period, a best corrected visual acuity of 0.0 LogMAR, an absolute refractive error ≤ 0.75 Diopters and no change in postoperative corneal astigmatism.


1476 eyes of 907 patients were randomized (736 in the FCS group and 740 in the PCS group). The mean age was 72.3+/-8.6 years, mean and median nuclear opacity (NO) grades were 3.3+/-1.2 and 3.1 (min:0.0-first quartile:2.6- third quartile: 4.0-max:6.9) respectively without significant differences between the two groups. For NO grade ≤ 3.1, the success rate was 59.9% in the FCS and 56.0% in the PCS group (Odds ratio (OR): 1.12 (95%Confidence Interval (CI): 0.74;1.7), p=0.577). For NO grade >3.1, the success rate was 46.8% in the FCS group and 53.1% in the PCS group (OR: 0.77 (95%CI: 0.52;1.14), p=0.187).


Femtosecond laser and phacoemulsification cataract surgery techniques exhibited comparable success rates in a large population sample. We did not observe any significant difference of success rate between the 2 groups for either harder or softer cataract severity grades. Further explorations are still needed to evaluate the clinical benefit of FCS over PCS for patients.

Financial Disclosure:


Back to previous