Femtosecond Laser-Assisted Cataract Surgery —Conclusive Evidence of Lack of Incremental Value

B énard and colleagues report a detailed cost-utility study of femtosecond laser-assisted cataract surgery (FLACS) in comparison with standard phacoemulsification cataract surgery (PCS) and did not find FLACS to be cost-effective. FLACS was introduced into cataract surgical practice about 12 years ag o with much excitement and anticipation. Here was an elegant procedure with the promise of greater precision and enhanced clinical outcomes compared with conventional ultrasound phacoemulsification for cataract surgery, the most performed operation. For many years, achievement of that promise was cl aimed based on small studies from enthusiastic early adopters. However, the strength of evidence showing no incremental benefit is now substantial. In fact, I believe that there are now more high-quality clinical research studies assessing the comparative outcomes of these competing procedures than available for any other ophthalmic surgical procedure in recent decades. In addition to large and well-controlled observational studies, such as that from a European registry, there have been 2 recent, well-powered, randomized clinical trials (RCTs) with similar results. From the UK, Day et al repor ted 3- and 12-month results of an RCT with 785 participants randomly assigned to either FLACS or PCS and found FLACS to be noninferior, with no difference in masked assessments of unaided distance vision, corrected visual acuity, patient-reported outcomes, and achievement of the refractive targ...
Source: JAMA Ophthalmology - Category: Opthalmology Source Type: research