title: Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: outcomes and safety in more than 4000 cases at a single center.
abstract: OBJECTIVE
  To compare the intraoperative complications and safety of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery.
  
  
  METHODS
  Single center.
  
  
  METHODS
  Prospective consecutive comparative cohort case series.
  
  
  METHODS
  Eyes had femtosecond laser-assisted cataract surgery (study group) or phacoemulsification (control group) by 1 of 5 surgeons. The technique comprised manual corneal incisions and capsulorhexis or laser-assisted anterior capsulotomy, lens fragmentation, corneal incisions, phacoemulsification, and intraocular lens implantation.
  
  
  RESULTS
  The study group comprised 1852 eyes and the control group, 2228 eyes. Patient demographics were similar between groups. There was a significant improvement in vacuum/docking attempts, surface recognition adjustments, treatment, and vacuum time during the laser procedure in the study group. Anterior capsule tears occurred in 1.84% of eyes in the study group and 0.22% of eyes in the control group (P < .0001). There was no difference in the incidence of anterior capsule tears between the first half and second half of laser-assisted cases. Anterior capsulotomy tags occurred in 1.62% study group eyes. There was no significant difference in posterior capsule tears between the 2 groups (0.43% versus 0.18%). The incidence of significant intraoperative corneal haze and miosis was higher and the effective phacoemulsification time significantly lower in the study group (P < .001).
  
  
  CONCLUSIONS
  Significant intraoperative complications likely to affect refractive outcomes and patient satisfaction were low overall. The 2 cataract surgery techniques appear to be equally safe. Although anterior capsule tears remain a concern, the safety of femtosecond-assisted cataract surgery in terms of posterior capsule complications was equal to that of phacoemulsification.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
authors.forename: Robin G
authors.initials: RG
authors.lastname: Abell
authors.affiliation: From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
authors.forename: Erica
authors.initials: E
authors.lastname: Darian-Smith
authors.affiliation: From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Kan
authors.affiliation: From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
authors.forename: Penelope L
authors.initials: PL
authors.lastname: Allen
authors.affiliation: From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
authors.forename: Shaun Y P
authors.initials: SY
authors.lastname: Ewe
authors.affiliation: From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia. Electronic address: eye.vote@bigpond.net.au.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: Vote
mesh_terms: D000368:Aged; D002387:Cataract Extraction; D063171:Corneal Pachymetry; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D053685:Laser Therapy; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology