Eyeworld

EW CATARACT 34 November 2015 92.9% had no difficulty in the phaco group. Preoperative complications that did occur were linked largely to previous corneal refractive surgery (4%) in the femto group, and a small percentage had issues with white cataracts, pseudoexfoliation, previ- ous vitrectomy, corneal opacities, and small pupils in both groups. All patients showed similar issues with preoperative ocular comorbidity. In both groups, more than 80% of patients had no ocular comorbidities, with glaucoma, age-related macular degeneration (AMD), diabetic retinopathy, and amblyopia among some of the issues that could potentially occur (though these occurred only in a small per- centage of patients in the groups). Preoperative complications in the study were also few, but the phaco group had less complications than the femto group. Only 1.5% of those in the phaco group showed any complications, while 2.9% in the femto group had compli- cations. Potential issues included torn posterior capsule, vitreous loss, dropped nucleus, and iris damage. The complications measured did not factor in femtosecond laser-specific complications. Postoperative complications were seen in only a fraction of patients (3.4% in the femto group and 2.3% in the phaco group). These included corneal edema, early PCO, uveitis, uncontrolled IOP, and IOL explantation. In terms of postoperative visual acuity, the phaco group had slightly better results, with 89.3% in this group showing improvement and 86% in the femto group showing improvement. In the femto group, 3.3% of patients had worse postop visual acuity compared to 1.3% in the phaco group, Dr. Barry said. This decreased vision was due to postop- erative complications, he added. Postoperative cylinder and postoperative surgically induced astigmatism were also compared in the study. The femto group showed 9% of patients with greater than or equal to 1.5 D of postoperative cylinder, while the phaco group had 18.5%. "It's important to identify what we did measure and what we didn't measure," Dr. Barry said. Factors that were measured in the study were surgical difficulty, ocular comorbidi- ty, preop complications, monofocal vs. premium IOLs, postoperative complications, visual acuity, biom- etry prediction error, postoperative cylinder, and surgically induced astigmatism. Factors that were not measured were circularity of the rhexis, centration of the rhexis, absolute phaco energy, the femto platform that was used, endothelial cell loss, effective lens positioning, and higher order aberrations. For the factors not measured, there were no comparisons in the EUREQUO database. So does femto outperform pha- co? It's true that femto patients have less postoperative astigmatism and less surgically induced astigmatism, Dr. Barry said. However, the femto patients also had worse postoper- ative visual acuity and more post- operative complications, and there were more patients in this group with postoperative visual acuity worse than it was preoperatively. Therefore, Dr. Barry said in terms of this study, "femto currently does not outperform phaco." EW Editors' note: Dr. Barry has no financial interests related to this article. Contact information Barry: peterbarryfrcs@theeyeclinic.ie Update continued from page 33 Only the HOLOS IntraOp ™ Wavefront Aberrometer continuously streams patient refractive data. Meaning you'll get a non-stop look at your procedure as it changes. And see cataract surgery in a whole new light. With HOLOS, precision doesn't pause —and neither will you. Really real time. ©2015 Clarity Medical Systems Inc. PN 100331 09/15 HOLOS.com Now available in the United States

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