SLOW UPTAKE IN FEMSTOSECOND-LASER ASSISTED CATARACT SURGERY

Interest in femtosecond laser-assisted cataract surgery remains high, but only two per cent of European and four per cent of US surgeons performed the procedure in 2011, while only four per cent and three per cent respectively said they planned to add it within the next six months, according to the latest surveys of ESCRS and ASCRS members by David Leaming MD, Palm Springs, California, US.

The results were presented at the XXX Congress of the ESCRS in Milan, Italy. When asked what was keeping them from doing laser cataract surgery, “not cost effective†was the top response at 67 per cent in Europe and 78 per cent in the US, followed by “no good data to prove it’s better†at 32 per cent in Europe and 46 per cent in the US. Surgeons also expressed concern about the extra time laser cataract surgery would take with “takes too long†listed as a factor by 15 per cent in Europe and 27 per cent in the US.

While overall interest in laser cataract surgery was high, the level of interest in specific aspects of laser surgery varied considerably. European surgeons rated laser capsulorhexis and laser lens softening an average of +8 and +7 respectively, while Americans ranked them -13 and -15. However, US surgeons gave laser limbal relaxing incisions a +20 compared with -7 for Europeans. Differences also were seen in techniques for correcting astigmatism at cataract surgery.

While 19 per cent of European and 10 per cent of US surgeons reported no change in technique or operating on the same axis in patients with significant astigmatism, 21 per cent of European and six per cent of US surgeons reported operating on the steep axis, 12 per cent and five per cent respectively reported using LRIs, and three per cent and two per cent used excimer surgery after cataract surgery. Toric IOLs remained the most common astigmatism correction approach, with 43 per cent of Europeans using them in patients with significant astigmatism – up five per cent from 2010 – and 66 per cent of US surgeons.

In a separate question on types of IOLs used overall, toric IOLs were the most common premium IOL, with 61 per cent of European surgeons using them, up 12 per cent from last year, and 85 per cent of US surgeons. By comparison, 44 per cent of European and 72 per cent of US surgeons used multifocal IOLs, and accommodating IOLs were used by only 12 per cent in Europe and 25 per cent in the US, down seven per cent from 2010. Intracameral antibiotics remained much more popular in Europe with 60 per cent reporting using them, compared with 18 per cent in the US, though this figure has risen slowly over the years.

Bilateral same-day cataract surgery also was more common in Europe at nine per cent, compared with just 0.4 per cent in the US. Finland reported the highest bilateral rates at 65 per cent followed by Sweden at 32 per cent and Serbia at 29 per cent. The surveys reported were concluded in November 2011, with 512 responses from 3,660 email invitations to ESCRS and 463 responses to 4,649 e-mail invitations to ASCRS members. These are the 13th annual ESCRS and 28th annual ASCRS surveys.