FLACS has not reached its ‘peak’ – here’s why
Mitch Jackson |
Back in the early days of phacoemulsification technology, there were people who didn’t believe in it. Now, we have ‘naysayers’ who say femtosecond laser-assisted cataract surgery (FLACS) has reached its peak. But I believe FLACS is here to stay.
I am a ‘femto guy’ – I use it in over 80 percent of my cases. Why? Because it offers me better outcomes for my patients than conventional phaco surgery. In terms of safety, FLACS delivers less energy into the eye, and is associated with less endothelial cell loss, corneal edema and a 50 percent lower rate of vitreous loss (1)(2)(3). Most importantly, FLACS delivers significantly faster visual recoveries to patients; one day after surgery, FLACS patients who had dense cataracts removed can see three lines better than patients who received phaco surgery (4). FLACS also has superiority as a cataract refractive tool. As effective lens position is partially determined by where you place the capsulotomy – important for multifocal or EDOF lenses – an advantage of FLACS is that the capsulotomy can be centered more precisely on the optic axis. There’s no way a manual capsulorhexis can be placed as perfectly! Also, astigmatism can be managed using femto through the placement of precise, customized arcuate incisions. Recently, LENSAR received approval to create anterior capsule ‘nubs’ to enhance accuracy of alignment when toric IOLs are used for astigmatism correction. Cyclorotation errors are minimized significantly with this new femto adjunct to my armamentarium.
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