Preliminary results of ESCRS/EUREQUO FLACS Study show femto and phaco comparable

The preliminary results of the joint ESCRS/EUREQUO FLACS (femtosecond laser-assisted cataract surgery) Study demonstrate that, even in different patient populations, results are similar in FLACS and phacoemulsification, Peter Barry, MD, Dublin, Ireland, said at the symposium “Why Bother with Femto-assisted Cataract Surgery?”

“If you apply the quality outcome measures, which are utilized in EUREQUO, which are specifically visual acuity, biometry prediction error, surgically induced astigmatism, torn posterior capsule, vitreous loss, and dropped nucleus, despite 2 different patient populations emerging from this study, the basic EUREQUO quality outcomes in these 2 groups are essentially the same,” Dr. Barry said.

“In this regard, I must stress that these are preliminary results. The study is ongoing,” he said.

The purpose of the study is to answer the question “Does femto outperform phaco?” Dr. Barry said. Recruitment to the femto group began in Dec. 2013 at 16 centers in 10 countries in Europe, with a total of 2,022 patients.

The phaco comparison group came from a selection of 100,000 patients from the European Registry of Quality Outcomes for Cataract and Refractive Surgery, or EUREQUO, from 2012-2013, Dr. Barry said. Of those, 5,000 were randomly selected, which was then reduced to 4,992. That amount was compared to the 2,022 femto patients with EUREQUO measures for quality outcomes.

In highlighting the differences between the groups, one of the most striking was the age difference, Dr. Barry said—patients in the phaco group were nearly 10 years older than those in the femto group.

“Another striking preoperative characteristic was the preoperative visual acuity,” Dr. Barry said. “[In] the femto group, 17.6% had a pre-cataract surgery best corrected distance visual acuity (BCDVA) of 1.0 or better, compared to only 4.5% in the phaco group.”

Another compelling fact in the two groups: “the higher rate in the femto group of patients [5.2%, compared to 0.2% in the phaco group] who have undergone previous corneal refractive surgery prior to having cataract,” he said.

Postoperative complications were higher in the femto group, at 3.2%, compared to 1.8% in phaco. Complications identified as “other” were the most common in that group, at 1.7%, followed by early posterior capsular opacification reducing visual acuity at 0.6% (compared to 0.1% in the phaco group).

In postoperative BCDVA, the femto group had slightly better results than the phaco group, Dr. Barry said. There was no real difference between the groups in targeting postop biometry prediction error.

The femto group had more postop complications, less postop astigmatism, and somewhat less surgically induced astigmatism than the phaco group, Dr. Barry said.

The study does have limitations, including circularity and centration of the capsulorhexis, endothelial cell loss, and effective lens position, he said, because there is no comparison for these in the EUREQUO database benchmarks.

Article from EyeWorld News.

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