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Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials.

Chen X, Xiao W, Ye S, Chen W, Liu Y - Sci Rep (2015)

Bottom Line: FLACS achieved a better visual outcome at postoperative 1 week and 6 months, but the difference was not significant at postoperative 1-3 months.In conclusion, femtosecond laser pretreatment can reduce phaco energy and EPT, which may reduce the heat damage to ocular tissues by ultrasound.Well-designed RCTs with longer follow-up are still necessary to provide more reliable evidence.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.

ABSTRACT
The aim of this study was to evaluate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery (CPCS) in the treatment of cataract. Randomized controlled trials (RCTs) were searched in PubMed, Embase and the Cochrane Central Register of Controlled Trials. Nine qualified studies with a total of 989 eyes were included. Compared with CPCS, FLACS significantly reduced mean phaco energy and effective phacoemulsification time (EPT) required in the surgery. Central corneal thickness (CCT) was significantly lower in FLACS at 1 day of follow-up, but CCT and corneal endothelial cells count was comparable at 1 week of follow-up or longer. FLACS achieved a better visual outcome at postoperative 1 week and 6 months, but the difference was not significant at postoperative 1-3 months. Regard to surgical complications, the incidences of intraoperative anterior capsule tear, postoperative macular edema and elevated intraocular pressure were similar. In conclusion, femtosecond laser pretreatment can reduce phaco energy and EPT, which may reduce the heat damage to ocular tissues by ultrasound. This novel technique might be beneficial for patients with dense cataract and/or low preoperative endothelial cell values. Well-designed RCTs with longer follow-up are still necessary to provide more reliable evidence.

No MeSH data available.


Related in: MedlinePlus

Forest plots displaying the effect of FLACS versus CPCS on uncorrected distance visual acuity (UDVA) at postoperative 1 week, 1 month and 6 months.
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f2: Forest plots displaying the effect of FLACS versus CPCS on uncorrected distance visual acuity (UDVA) at postoperative 1 week, 1 month and 6 months.

Mentions: Seven studies reported postoperative uncorrected distance visual acuity (UDVA)192333 and corrected distance visual acuity (CDVA)19232633 as a logarithm of the minimal angle of resolution (logMAR) at different time points. Examination of the forest plots revealed no statistically significant differences in postoperative UDVA between FLACS versus CPCS groups during the follow-up period (Fig. 2). However, the differences of postoperative CDVA were statistically significant at 1 week (mean difference = −0.05, 95% CI −0.07 to −0.03, P < 0.001) and 6 months (mean difference = −0.04, 95% CI −0.07 to −0.01, P = 0.020), but the differences were not significant at 1–3 months (mean difference = −0.01, 95% CI −0.06 to 0.03, P = −.051) (Fig. 3).


Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials.

Chen X, Xiao W, Ye S, Chen W, Liu Y - Sci Rep (2015)

Forest plots displaying the effect of FLACS versus CPCS on uncorrected distance visual acuity (UDVA) at postoperative 1 week, 1 month and 6 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4542520&req=5

f2: Forest plots displaying the effect of FLACS versus CPCS on uncorrected distance visual acuity (UDVA) at postoperative 1 week, 1 month and 6 months.
Mentions: Seven studies reported postoperative uncorrected distance visual acuity (UDVA)192333 and corrected distance visual acuity (CDVA)19232633 as a logarithm of the minimal angle of resolution (logMAR) at different time points. Examination of the forest plots revealed no statistically significant differences in postoperative UDVA between FLACS versus CPCS groups during the follow-up period (Fig. 2). However, the differences of postoperative CDVA were statistically significant at 1 week (mean difference = −0.05, 95% CI −0.07 to −0.03, P < 0.001) and 6 months (mean difference = −0.04, 95% CI −0.07 to −0.01, P = 0.020), but the differences were not significant at 1–3 months (mean difference = −0.01, 95% CI −0.06 to 0.03, P = −.051) (Fig. 3).

Bottom Line: FLACS achieved a better visual outcome at postoperative 1 week and 6 months, but the difference was not significant at postoperative 1-3 months.In conclusion, femtosecond laser pretreatment can reduce phaco energy and EPT, which may reduce the heat damage to ocular tissues by ultrasound.Well-designed RCTs with longer follow-up are still necessary to provide more reliable evidence.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, People's Republic of China.

ABSTRACT
The aim of this study was to evaluate the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery (CPCS) in the treatment of cataract. Randomized controlled trials (RCTs) were searched in PubMed, Embase and the Cochrane Central Register of Controlled Trials. Nine qualified studies with a total of 989 eyes were included. Compared with CPCS, FLACS significantly reduced mean phaco energy and effective phacoemulsification time (EPT) required in the surgery. Central corneal thickness (CCT) was significantly lower in FLACS at 1 day of follow-up, but CCT and corneal endothelial cells count was comparable at 1 week of follow-up or longer. FLACS achieved a better visual outcome at postoperative 1 week and 6 months, but the difference was not significant at postoperative 1-3 months. Regard to surgical complications, the incidences of intraoperative anterior capsule tear, postoperative macular edema and elevated intraocular pressure were similar. In conclusion, femtosecond laser pretreatment can reduce phaco energy and EPT, which may reduce the heat damage to ocular tissues by ultrasound. This novel technique might be beneficial for patients with dense cataract and/or low preoperative endothelial cell values. Well-designed RCTs with longer follow-up are still necessary to provide more reliable evidence.

No MeSH data available.


Related in: MedlinePlus