Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification: A meta-analysis of randomized controlled trials

Author:

Pichardo-Loera Nicole Stephanie1,Corredor-Ortega Claudia1,Castro-Monreal Miguel Angel1,Massaro-Corredor Martha Gabriela1,Pérez-Vázquez José Francisco1,Gonzalez-Salinas Roberto1ORCID

Affiliation:

1. Anterior Segment Department, Asociación Para Evitar la Ceguera en México I.A.P., Mexico City, Mexico

Abstract

Purpose The main purpose of our study is to compare the adverse events occurrence, complications, and postoperative outcomes of Femtosecond Laser-Assisted Cataract Surgery (FLACS) versus conventional phacoemulsification surgery (CPS) in adult patients undergoing cataract surgery. Methods We conducted our research using PubMed, Scopus, and MEDLINE through EBSCOhost from 2012 to July 2022 with English and Spanish language restriction, including only Randomized Controlled Trials (RCTs). The PRISMA guidelines were observed for data abstraction, including a random-effects model for each outcome. Results We analyzed 4844 eyes from 23 RCTs with some low risk of bias according to RoB 2 tool. We found statistically significant differences between the FLACS and CPS groups for the mean absolute error (MD = −0.12, 95% CI:−0.22–[−0.02], p = 0.01), the circularity of capsulorhexis (MD = 0.04, 95% CI: 0.04–0.05, p ≤ 0.00001), IOL centration ( D = −0.07, 95% CI:−0.09–[−0.05], p ≤ 0.00001), CDE count (MD = −1.75, 95% CI: −2.75-[−0.74], p = 0.0006), mean phacoemulsification time (MD = -12.90, 95% CI:−20.89-[−4.92], p = 0.002), EPT (MD = −0.93, 95% CI: −1.68-[−0.019], p = 0.01) and endothelial cell density loss ((MD = −0.6, 95% CI: −1-[−0.19], p = 0.004). Also, the safety analysis showed a lower incidence of posterior capsule tear (PCT) in the FLACS group (OR =0.29, 95% CI: 0.09–1, p = 0.05). Conclusions Our results suggest that FLACS might be helpful for patients with relatively dense cataracts and low preoperative endothelial cell values.

Funder

Asociación para Evitar la Ceguera en México I.A.P.

Publisher

SAGE Publications

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