This website was set up in 2013 (before there was a textbook on LenSx Laser Cataract Surgery) to help surgeons share their collective experiences. It is now an “open textbook” and has been updated after nearly 3,000 operations to ensure the information is current.
This site is “open” to all and can be viewed by cataract surgeons who would like to understand the challenges facing colleagues who have switched to laser cataract surgery. It allows one to see how issues are being addressed in this exciting and evolving new field.
Prior to 2014, there was a “LenSx Laser Portal” where surgeons using the laser could update their colleagues daily with respect to their experiences, and this was shared by all users of the laser. This site is no longer available – surgeons now starting laser cataract surgery must learn from their peers.
Our Unit was the first unit in Melbourne to complete 1,000 LenSx procedures. We have pooled our collective experience to be shared with our colleagues.
I am often asked if laser surgery is safer than manual cataract surgery. The evidence-based answer I give is this:
In 2019, a definitive, randomised, prospective study demonstrated that patients who had their cataracts removed using FLACS had a lower serious complication rate than those who had manual cataract surgery.1 This was not surprising as a previous study in 2013 showed that when surgeons changed from manual cataract surgery to FLACS the complication rate decreased for all the surgeons involved.2 In 2017, a study carried out by 18 cataract clinics in nine European countries and Australia also showed that FLACS had an extremely low posterior capsular rupture rate of less than 1%.3 When registrars were training and learning how to perform cataract surgery, their patients who had FLACS were shown to have less serious complications than those who had manual cataract surgery.4
It is important to note that no study has shown that FLACS gives a better visual outcome than manual cataract surgery, but evidence-based research now shows that FLACS is safer with regards to the serious complication of posterior capsular rupture.
I am indebted to the ophthalmologists of Vision Eye Institute in Sydney Australia for sharing their pioneering experiences with me, and to my colleagues in Melbourne for their keenness in adopting this new technology.
I would like to thank Alcon for the structured training program and personal guidance all LenSx surgeons receive. Please note I am not associated with Alcon or LenSx, apart from being an enthusiastic user of the technology.
Dr Lewis Levitz
MBBCh, MMed, FCS(SA)(Ophth) FRCSEd FRANZCO
Roberts, H. W., Wagh, V. K., Sullivan, D. L., Hidzheva, P., Detesan, D. I., Heemraz, B. S., … O’Brart, D. P. S. (2018). A randomized controlled trial comparing femtosecond laser–assisted cataract surgery versus conventional phacoemulsification surgery. Journal of Cataract and Refractive Surgery. https://doi.org/10.1016/j.jcrs.2018.08.033 ↩︎
Scott, W. J., Tauber, S., Gessler, J. A., Ohly, J. G., Owsiak, R. R., & Eck, C. D. (2016). Comparison of vitreous loss rates between manual phacoemulsification and femtosecond laser–assisted cataract surgery. Journal of Cataract & Refractive Surgery, 42(7), 1003–1008. https://doi.org/10.1016/j.jcrs.2016.04.027 ↩︎
Lundström, M., Dickman, M., Henry, Y., Manning, S., Rosen, P., Tassignon, M. J., … Sunga, C. (2017). Femtosecond laser–assisted cataract surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery: Baseline characteristics, surgical procedure, and outcomes. In Journal of Cataract and Refractive Surgery. https://doi.org/10.1016/j.jcrs.2017.09.029 ↩︎
Brunin, G., Khan, K., Biggerstaff, K. S., Wang, L., Koch, D. D., & Khandelwal, S. S. (2017). Outcomes of femtosecond laser-assisted cataract surgery performed by surgeons-in-training. Graefe’s Archive for Clinical and Experimental Ophthalmology, 255(4), 805–809. https://doi.org/10.1007/s00417-016-3581-x ↩︎