Optimising cataract surgery outcomes
New technology for cataract surgery prevails when it provides clear advantages


Cheryl Guttman Krader
Published: Wednesday, March 22, 2017

We have seen before that new technology for cataract surgery prevails when it provides clear advantagesNegatives and unknowns Dr Nagy acknowledged that the many of the benefits of using the femtosecond laser for capsulotomy may be mostly relevant to cases involving multifocal IOLs. And, he admitted that excellent outcomes can also be achieved using a manual technique. However, predictability for achieving a perfect capsulotomy is poorer with a manual approach, especially considering that multifocal IOL cases generally involve younger patients who refuse anything more than topical anesthesia and so have a tendency to move. Problems that have been reported with FLACS include suction breaks, conjunctival redness, and capsular blockage syndrome along with increased rates of anterior capsule tears, intraoperative miosis, and corneal endothelial loss. Dr Nagy suggested, however, that some of these issues are learning curve-related and others have been addressed by hardware improvements and modifications in surgical technique. Still, more time is needed to determine whether FLACS is safer overall than traditional phacoemulsification and if it is associated with less posterior capsule opacification (PCO), Dr Nagy said. “The effect of FLACS on PCO is debated in the literature. Experience in our series suggests the rate of PCO is lower after FLACS, but there is some opacity under the laser cut. Therefore, we need a few more years of follow-up,” he stated. Zoltan Z. Nagy, MD nagy.zoltan_zsolt@med.semmelweis-univ.hu
Tags: cataract
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