Outcomes of femtosecond laser-assisted cataract surgery performed by surgeons-in-training.

Objective: To compare intraoperative factors and post-operative outcomes of femtosecond laser-assisted cataract surgery (FLACS) and manual cataract surgery performed by resident surgeons.

Methods: All cases of FLACS performed by resident surgeons during the 2013-2014 academic year were compared to a control group of manual cataract surgery cases with regards to pre-operative patient data, operative complications, cumulative dissipated energy (CDE), postoperative corrected distance visual acuity (CDVA), refractive prediction error (RPE), and corneal edema.

Results: There were no significant preoperative differences in the FLACS (n = 57) and manual (n = 68) groups. Operative complication rates were similar in cases with sufficient data and follow-up with a higher rate of posterior capsule tear in the manual group. CDE (percent-seconds) was lower in the FLACS group (FLACS: 14.5 ± 7.5; manual: 21.6 ± 11.5; p < 0.01). CDVA (LogMAR) was comparable at 1 month postoperatively (FLACS: 0.004 ± 0.08; manual: 0.024 ± 0.11; p = 0.24) and 1 year postoperatively (FLACS: 0.013 ± 0.06; manual: 0.032 ± 0.09; p = 0.37). No difference in RPE was found at 1 month postoperatively (FLACS: 0.38 ± 0.24 D; manual: 0.41 ± 0.49 D; p = 0.66) and 1 year postoperatively (FLACS: 0.49 ± 0.63 D; manual: 0.34 ± 0.26 D; p = 0.31).

Conclusions: Femtosecond laser-assisted cataract surgery is safe and effective compared to manual cataract surgery when performed by resident surgeons. Both 1-month and 1-year outcomes show no difference in refractive predictive error in FLACS compared to manual cataract surgery in surgeons in training.