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Meta-Analysis
. 2015 Aug 13:5:13123.
doi: 10.1038/srep13123.

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

Xiaoyun Chen  1 , Wei Xiao  1 , Shaobi Ye  1 , Weirong Chen  1 , Yizhi Liu  1
Affiliations
Meta-Analysis

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

Xiaoyun Chen et al. Sci Rep. .

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.

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Figures

Figure 1
Figure 1. Flow chart of literature search and study selection.
Figure 2
Figure 2. Forest plots displaying the effect of FLACS versus CPCS on uncorrected distance visual acuity (UDVA) at postoperative 1 week, 1 month and 6 months.
Figure 3
Figure 3. Forest plot exhibiting the effect of FLACS versus CPCS on corrected distance visual acuity (CDVA) at postoperative 1 week, 1–3 months and 6 months.
Figure 4
Figure 4
(a) Forest plots showing the effect of FLACS versus CPCS on the corneal endothelial cell counts at postoperative 1 week and 4–6 weeks. (b) Forest plots displaying the effect of FLACS versus CPCS on the central corneal thickness (CCT) at postoperative 1 day and 1 week.
Figure 5
Figure 5
Forest plots revealing the effect of FLACS versus CPCS on mean phaco energy (a), mean phaco time (b), and effective phaco time (EPT) used in the surgery.
Figure 6
Figure 6
(a) Forest plots representing the effect of FLACS versus CPCS on the circularity of capsulorrhexis at postoperative 1 week. (b) Forest plots showing the incidences of intraoperative and postoperative complications in FLACS versus CPCS.
See this image and copyright information in PMC

References

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