Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases.

OBJECTIVE To report the surgical outcomes and safety of femtosecond (FS) laser cataract surgery (LCS) with greater surgeon experience, modified techniques, and improved technology. DESIGN Prospective, interventional case series. PARTICIPANTS Fifteen hundred consecutive eyes undergoing FS laser cataract and refractive lens exchange surgery in a single group private practice. INTERVENTION Femtosecond LCS. METHODS All eyes undergoing LCS between April 2011 and March 2012 were included in the study. Cases underwent anterior capsulotomy, lens fragmentation, and corneal incisions with the Alcon/LenSx FS laser (Alcon/LenSx, Aliso Viejo, CA). The procedure was completed by phacoemulsification and insertion of an intraocular lens. The cases were divided into 2 groups: Group 1, initial experience consisting of the first 200 cases; and group 2, the subsequent 1300 cases performed by the same surgeons. MAIN OUTCOME MEASURES Intraoperative complication rates and comparison between groups. RESULTS Both groups were comparable for baseline demographic parameters. Anterior capsule tears occurred in 4% and 0.31% of eyes, posterior capsule tears in 3.5% and 0.31% of eyes, and posterior lens dislocation in 2% and 0% of eyes in groups 1 group 2, respectively (P<0.001 for all comparisons). Number of docking attempts per case (1.5 vs 1.05), incidence of post-laser pupillary constriction (9.5% vs 1.23%), and anterior capsular tags (10.5% vs 1.61%) were significantly lower in group 2 (P<0.001 for all comparisons). CONCLUSIONS In the authors' experience, the surgical outcomes and safety of LCS improved significantly with greater surgeon experience, development of modified techniques, and improved technology.

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