EyeWorld Asia-Pacific June 2016 Issue

June 2016 EWAP FEATURE 9 Femto in cataract surgery: The state of the technology by Liz Hillman EyeWorld Staff Writer With FLACS still in its infancy, physicians discuss the research, bringing it to practice, and education T he femtosecond laser is not the first and it’s certainly not the last of new technologies that could revolutionize the way physicians perform cataract surgery. But the jury is still out on whether the technology—approved by the U.S. Food and Drug Administration for this purpose in 2010—trumps traditional cataract surgery technique. Within the last decade, hundreds of studies involving femtosecond laser-assisted cataract surgery (FLACS) have been published, with more to come. So what does the current research have to say? How are physicians currently bringing it into their practice? And how is it being introduced to residents? “I think ophthalmology in general is still trying to grapple AT A GLANCE • 8IJle ToNe reDeOU TUVdJeT DJUe adWaOUageT Uo '-"$4 oUIerT IaWe foVOd oVUDoNeT are OoU TJgOJàDaOUly dJffereOU DoNQared Uo NaOVal DaUaraDU TVrgery. • 1IyTJDJaOT CrJOgJOg feNUo JOUo QraDUJDe TIoVld DoOTJder QaUJeOU DoVOTelJOg addJUJoOal DoTUT aOd oQeraUJOg UJNe. • &dVDaUorT are oQeO Uo UraJOJOg reTJdeOUT oO feNUo CVU Vrge a iDaVUJoVTly oQUJNJTUJDu aQQroaDI Uo JU. with … how do we optimize the usefulness of the femtosecond laser in our practices,” said Saras Ramanathan, MD , associate professor of ophthalmology, University of California, San Francisco (UCSF) School of Medicine. “Ophthalmologists in this country are still trying to figure out how the femtosecond laser fits into their practices—we don’t all agree.” All eyes on the data A study of 4,000 cases from a single center in Tasmania published in 2015 in the Journal of Cataract & Refractive Surgery found that both FLACS and traditional cataract surgery were safe and had low intraoperative complications that could affect refractive outcomes and patient satisfaction. 1 A 6-month follow-up study comparing the outcomes of FLACS and manual phaco surgery by Yu et al. published in December 2015 in Clinical & Experimental Ophthalmology found similar safety and efficacy between both procedures. 2 A separate 6-month follow-up study published in July 2015 in the Journal of Cataract & Refractive Surgery compared visual recovery and refractive stability between the two procedures and found that FLACS resulted in faster visual recoveries and more stable refractive results, compared to manual cataract surgery. 3 As for visual acuity, a literature review published in Current Opinion in Ophthalmology in January 2014 found that “most but not all existing studies showed no statistically significant difference in visual acuity and mean absolute refractive error between laser and conventional cataract surgery cases.” 4 There was also a 2013 review published in Eye , the journal of the Royal College of Ophthalmologists, that cited several studies that concluded femtosecond laser use Dr. Ramanathan teaches resident Chris Aderman how to use the femtosecond laser to create corneal incisions and capsulorhexis in a patient at UCSF Medical Center. Source: UCSF continued on page 10