Abstract
Purpose :
The use of Femtosecond laser assisted cataract surgery (FLACS) has become more widespread in recent years. The purpose of this study was to compare operative time required for FLACS versus conventional phacoemulsification.
Methods :
We conducted a retrospective study in a large ophthalmology private practice on all uncomplicated cataract surgeries performed from November 2013 to December 2015. Demographic and intraoperative variables collected prospectively at the time of surgery include surgeon, phaco energy as measured by cumulative dissipated energy (CDE), total intraoperative time (OR time), patient age, operative eye, procedure performed, intraocular lens (IOL) power and type, patient allergies, past medical history, and ASA rating. Total intraoperative time included only time spent in the operating room. Bivariate analysis was performed with OR time as a dependent variable. Surgeon, type of surgery, CDE, right or left eye, and age were independent variables. Multivariable analysis was performed on age and all variables that were significant using bivariate analysis.
Results :
1885 surgeries were reviewed. 629 (33.4%) were FLACS cases, and 1252 (66.4%) were conventional phacoemulsification cases. The average age of patients was 71.18 +/- 19.89. The average intraoperative time overall was 13.51 +/- 14.88. Cases using FLACS had a mean operative time of 13.13 +/- 5.13 minutes as compared to conventional phacoemulsification which was 13.67 +/- 17.87 (P = 0.46). When stratified by surgeon, one surgeon had a small but significant increase in intraoperative time related to FLACS use vs. conventional phacoemulsification (10.19 +/- 3.57, 9.22 +/- 4.35, P = 0.01). Surgeon was associated with a significant difference in OR time P<0.001) as was CDE. Higher CDE was also associated with longer intraoperative time (P = 0.001). There was no association between intraoperative time and age (P = 0.45) or right or left eye (0.223). Multivariable analysis included age, CDE, and surgeon and showed that CDE and surgeon were both significantly associated with intraoperative time.
Conclusions :
FLACS use is not associated with a significant difference in operative time in this sample overall, but individually resulted in a small increase in intraoperative time for one surgeon. Higher CDE and surgeon were associated with longer intraoperative time overall.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.