Authors (including presenting author) :
Yeung LMT (1), Lau YH (1), Li ALW (1), Ho VWM (1), Li KKW (1)(2)(3)
Affiliation :
(1)Department of Ophthalmology, UCH
(2)Department of Ophthalmology, TKOH
(3)Wu Ho Loo Ning Cataract Centre, TKOH
Introduction :
Femtosecond laser assisted cataract surgery could benefit patients in offering precise wound incisions and astigmatic keratotomies, centered capsulotomies, and reduced phaco energy by fragmentation of lens.
Objectives :
To review the demographic data, operating time and energy used, intraoperative and postoperative complications, visual acuity improvement and refractive outcomes of FLACS cases performed in KEC.
Methodology :
This is a retrospective review of electronic records of patients who have received FLACS in Kowloon East Cluster from February 2023 to August 2024.
Result & Outcome :
A total of 75 eyes of 75 patients, with a mean age of 76, underwent FLACS during the study period. Forty-three was male and 32 were female. Morphology of cataract included 32 cases of cortical cataract, 25 nuclear sclerosis cataract, 16 posterior subcapsular cataract and 2 white cataract respectively. Twenty-two cases had astigmatic keratotomy in adjunct to FLACS for astigmatic correction.
Seventy-three percent cases were conducted within 20 minutes with less than 10J of total cumulative dissipated energy. Seventy-one (94.67%) cases showed visual improvement. Overall up to 23% have 3-fold increase in visual acuity compared with preoperative measurements.
Regarding intraoperative complications, there were 4 cases of anterior capsular tears, 2 cases of continuous curvilinear capsulorrhexis (CCC) rim extension and 1 case of posterior capsular rupture (PCR). Overall anterior rim complication rate was 8% and PCR rate was 1.33%
FLACS is a precise and reproducible technique for cataract surgery. The complication rate, visual outcome and refractive status were all comparable to conventional surgery. Our results showed that FLACS was safe to perform allowing surgery to be completed with a low CDE, hence less thermal damage to the endothelial cell due to low ultrasound energy dispensed. The challenges for surgeons remain in adopting these new surgical techniques, which has a relatively short learning curve. FLACS can be used to perform key steps in cataract surgery, with greater precision and reproducibility of these steps compared to manual techniques, to offer excellent visual outcomes to patients. Our results have shown that FLACS can be introduced safely and successfully into clinical practice of HA.
