Best Cataract Surgery in the World Usually Involves Femtosecond Laser Assisted Cataract Surgery

Eye Surgeons love using the Femtosecond laser for cataract surgery as it makes the whole surgery generally safer. Most of us have yet to have a complication using the Femotosecond laser for cataract surgery. 

Below is another paper that shows Femosecond laser to be superior to convential cataract surgery, particularly in patients with a narrow angle. A shallow angle was defined as an anterior chamber depth of <2.5 mm which is not uncommon. 

The laser cuts the cataract into pieces so the surgeon does not need as much energy and the need to be close to the corneal endothelium (the inner part of the window of the eye that has priceless endothelial cells that keep the cornea clear) is minimized. 

Most surgeons would choose the Femtosecond laser for their own eye or the surgery of a loved one. 

 2019 May;45(5):547-552. doi: 10.1016/j.jcrs.2018.11.037.

Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in eyes with a shallow anterior chamber.



To compare intraoperative performance and postoperative outcomes between femtosecond laser-assisted cataract surgery(FLACS) and conventional phacoemulsification in eyes with a shallow anterior chamber (AC).


Iladevi Cataract & IOL Research Centre, India.


Prospective randomized masked clinical study.


Patients undergoing cataract surgery with a shallow AC (<2.5 mm) were randomized to have FLACS (Group 1, n = 91) or conventional phacoemulsification (Group 2, n = 91). Patients were followed up at 1 day, 1 week, and at 1, 3, and 6 months. The primary outcome measure was central corneal thickness (CCT). The secondary outcome measures were corneal clarity, AC cells and flare, endothelial cell density (ECD), coefficient of variance, hexagonality, and uncorrected distance visual acuity (UDVA) at 1 week.


The study comprised 182 eyes (91 in each group) The cumulative dissipative energy was lower in the FLACS group (P < .05). The mean CCT was significantly lower with FLACS (540.40 μm + 49.40 [SD] vs 556 + 12.5 μm, P = .03) at 1 day and 1 week (535.5 + 44.3 μm vs 551 + 40.8 μm, P = .04), with fewer eyes having higher than grade 2 AC cells and flare with FLACS (85% vs 72%, P = .056) at 1 day and 1 week (15% vs 28%, P = .03). At 1 week, the UDVA was better with FLACS (0.089 ± 0.31 logarithm of the minimum angle of resolution [logMAR] vs 0.178 ± 0.65 logMAR, P = .042). At 6 months, the reduction in ECD was lower in the FLACS group; however, the difference was not statistically significant.


In eyes with shallow ACs, compared with conventional phacoemulsification, FLACS maintained clearer corneas, showed less increase in CCT, lower AC inflammation, and better UDVA in the early postoperative period. 

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