gms | German Medical Science

Cataract surgery today is one of the most safest surgery procedure in medicine. If a new technology will rise savety it has to proof that. Main Items of FLACS and premium IOL implantation that are in focus in respect of precision and savety are:

Incisions: There had been advices that incisions too corneal can facilitate a leakage and thus could enhence cases of endophthalmitis.

Problem: Incisions with the femtocataract laser systems are all clear corneal.

Limbal Relaxing Incisions (LRI): Recurrance of astigmatisme after 1–2 years is a common phenomen.

Problem: The more precise incisions with the laser did jet not proove results with longer stability.

Capsulotomy: problems with laser created capsulotomies as tags and bridges are still an issue, clinical outcomes with better results are not convincing.

Problem: it is jet not prooven, if capsulotomies with better precision contribute to more savety and better refractive outcomes.

Corneal Endothelium: reduction of U/S engery has jet not proven better outcomes in refractive cataract cases.

Problem: publicated results are to be questioned in respect to anterior chamber depth, pachymetrie and cell counting procedures.

Lens Fragmentation: those eyes most recommended for FLACS, refracitve lens surgery with implantation of premium IOL´s do not need pretreatmend of lens fragmentation.

Problem: no prooven saftey aspects.

Overall aspects: There is still a lack of the so called “wow effect” that makes it a “MUST” in contrast to the standard of care in cataract surgery: the U/S-phacoemulsification. The relationship of safety aspects and oeconomical burdens are jet not in balance.