title: Outcomes of femtosecond laser-assisted cataract surgery performed by surgeons-in-training.
abstract: OBJECTIVE
  To compare intraoperative factors and post-operative outcomes of femtosecond laser-assisted cataract surgery (FLACS) and manual cataract surgery performed by resident surgeons.
  
  
  METHODS
  All cases of FLACS performed by resident surgeons during the 2013-2014 academic year were compared to a control group of manual cataract surgery cases with regards to pre-operative patient data, operative complications, cumulative dissipated energy (CDE), postoperative corrected distance visual acuity (CDVA), refractive prediction error (RPE), and corneal edema.
  
  
  RESULTS
  There were no significant preoperative differences in the FLACS (n = 57) and manual (n = 68) groups. Operative complication rates were similar in cases with sufficient data and follow-up with a higher rate of posterior capsule tear in the manual group. CDE (percent-seconds) was lower in the FLACS group (FLACS: 14.5 ± 7.5; manual: 21.6 ± 11.5; p < 0.01). CDVA (LogMAR) was comparable at 1 month postoperatively (FLACS: 0.004 ± 0.08; manual: 0.024 ± 0.11; p = 0.24) and 1 year postoperatively (FLACS: 0.013 ± 0.06; manual: 0.032 ± 0.09; p = 0.37). No difference in RPE was found at 1 month postoperatively (FLACS: 0.38 ± 0.24 D; manual: 0.41 ± 0.49 D; p = 0.66) and 1 year postoperatively (FLACS: 0.49 ± 0.63 D; manual: 0.34 ± 0.26 D; p = 0.31).
  
  
  CONCLUSIONS
  Femtosecond laser-assisted cataract surgery is safe and effective compared to manual cataract surgery when performed by resident surgeons. Both 1-month and 1-year outcomes show no difference in refractive predictive error in FLACS compared to manual cataract surgery in surgeons in training.
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine Houston, Houston, Texas, USA.|Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Brunin
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine Houston, Houston, Texas, USA.
authors.forename: Khurrum
authors.initials: K
authors.lastname: Khan
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine Houston, Houston, Texas, USA.|Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Biggerstaff
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine Houston, Houston, Texas, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine Houston, Houston, Texas, USA.|Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Koch
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine Houston, Houston, Texas, USA. sumitra.khandelwal@bcm.edu.|Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA. sumitra.khandelwal@bcm.edu.
authors.forename: Sumitra S
authors.initials: SS
authors.lastname: Khandelwal
mesh_terms: D000368:Aged; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D009885:Ophthalmology / Q000193:education*; D018918:Phacoemulsification / Q000193:education* / Q000379:methods; D012189:Retrospective Studies; D066231:Surgeons / Q000193:education*
keywords: Cataract; Cataract surgery; Femtosecond laser-assisted cataract surgery; Resident training