Review scientific literature concerning femtosecond laser–assisted cataract surgery.
Methods:
Following databases were searched: CENTRAL (Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 2 of 12, June 2019), Ovid MEDLINE® without Revisions (1996 to June 2019), Ovid MEDLINE® (1946 to June 2019), Ovid MEDLINE® Daily Update June 2019, MEDLINE and MEDLINE Non-Indexed Items, Embase (1980–2019), Embase (1974 to June 2019), Ovid MEDLINE® and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to June 2019), Web of Science (all years), the metaRegister of Controlled Trials (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Search terms/keywords included ‘Femtosecond laser’ combined with ‘cataract’, ‘cataract surgery’.
Results:
Based on quality of their methodology and their originality, 121 articles were reviewed, including randomised controlled trials, cohort studies, case-controlled studies, case series, case reports and laboratory studies. Each step of the femtosecond laser–assisted cataract surgery procedure (corneal incisions, arcuate keratotomies, capsulotomy and lens fragmentation) has been discussed with relevance to published outcomes, as well as complication rates of femtosecond laser–assisted cataract surgery, and what we can learn from the larger studies/meta-analyses and the economics of femtosecond laser–assisted cataract surgery within different healthcare settings.
Conclusion:
Studies suggest that the current clinical outcomes of femtosecond laser–assisted cataract surgery are not different to conventional phacoemulsification surgery and it is not cost effective when compared with conventional phacoemulsification surgery. In its current technological form, it is a useful surgical tool in specific complex cataract scenarios, but its usage has not been shown to translate into better clinical outcomes.
NagyZTakacsAFilkornT, et al. Initial clinical evaluation of an intraocular femtosecond laser in cataract surgery. J Refract Surg2009; 25(12): 1053–1060.
2.
RobertsTVLawlessMChanCC, et al. Femtosecond laser cataract surgery: technology and clinical practice. Clin Exp Ophthalmol2012; 41: 180–186.
3.
SchumacherSFrommMOberheideU, et al. In vivo application and imaging of intralenticular femtosecond laser pulses for the restoration of accommodation. J Refract Surg2008; 24(9): 991–995.
4.
Conrad-HengererISchultzTJonesJJ, et al. Cortex removal after laser cataract surgery and standard phacoemulsification: a critical analysis of 800 consecutive cases. J Refract Surg2014; 30(8): 516–520.
5.
DayACSmithPRTangHL, et al. Surgical efficiency in femtosecond laser cataract surgery compared with phacoemulsification cataract surgery: a case-control study. BMJ Open2018; 8(2): e018478.
6.
MasketSSaraybaMIgnacioT, et al. Femtosecond laser-assisted cataract incisions: architectural stability and reproducibility. J Cataract Refract Surg2010; 36(6): 1048–1049.
7.
SerraoSGianniniDSchiano-LomorielloD, et al. New technique for femtosecond laser creation of clear corneal incisions for cataract surgery. J Cataract Refract Surg2017; 43(1): 80–86.
8.
SerraoSLombardoGSchiano-LomorielloD, et al. Preliminary investigation of corneal wavefront aberration following femtosecond laser clear corneal incision for cataract surgery. Eur J Ophthalmol2014; 24(6): 842–849.
9.
TitiyalJSKaurMRameshP, et al. Impact of clear corneal incision morphology on incision-site descemet membrane detachment in conventional and femtosecond laser-assisted phacoemulsification. Curr Eye Res2018; 43(3): 293–299.
10.
MastropasquaLTotoLMastropasquaA, et al. Femtosecond laser versus manual clear corneal incision in cataract surgery. J Refract Surg2014; 30(1): 27–33.
11.
GrewalDSBastiS.Comparison of morphologic features of clear corneal incisions created with a femtosecond laser or a keratome. J Cataract Refract Surg2014; 40(4): 521–530.
12.
WangXZhangZLiX, et al. Evaluation of femtosecond laser versus manual clear corneal incisions in cataract surgery using spectral-domain optical coherence tomography. J Refract Surg2018; 34(1): 17–22.
13.
RobertsTVLawlessMBaliSJ, et al. Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases. Ophthalmology2013; 120(2): 227–233.
14.
MayerWJKlaprothOKHengererFH, et al. In vitro immunohistochemical and morphological observations of penetrating corneal incisions created by a femtosecond laser used for assisted intraocular lens surgery. J Cataract Refract Surg2014; 40(4): 632–638.
15.
TotoLCurcioCMastropasquaA, et al. Immunohisto-chemical study of corneal inflammation after femtosecond laser clear corneal incisions or manual surgery. J Cataract Refract Surg2016; 42: 1649–1659.
16.
DonnenfeldERosenbergEBoozanH, et al. Randomized prospective evaluation of the wound integrity of primary clear corneal incisions made with a femtosecond laser versus a manual keratome. J Cataract Refract Surg2018; 44(3): 329–335.
17.
SongCBaharozianCJHatchKM, et al. Assessment of surgeon experience with femtosecond laser-assisted cataract surgery. Clin Ophthalmol2018; 12: 1373–1377.
18.
KhanMMuhtasebM.Prevalence of corneal astigmatism in patients having routine cataract surgery at a teaching hospital in the United Kingdom. J Cataract Refract Surg2011; 37(10): 1751–1755.
19.
DayACDhariwalMKeithMS, et al. Distribution of preoperative and postoperative astigmatism in a large population of patients undergoing cataract surgery in the UK. Br J Ophthalmol2019; 103(7): 993–1000.
20.
Ferrer-BlascoTMontés-MicóR.Prevalence of corneal astigmatism before cataract surgery. J Cataract Refract Surg2009; 35: 70–75.
21.
TahhanNPapasEFrickeTR, et al. Utility and uncorrected refractive error. Ophthalmology2013; 120(9): 1736–1744.
22.
NejimaRTeradaYMoriY, et al. Clinical utility of femtosecond laser-assisted astigmatic keratotomy after cataract surgery. Jpn J Ophthalmol2015; 59(4): 209–215.
23.
TitiyalJSKhatikMSharmaN, et al. Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification. J Cataract Refract Surg2014; 40(5): 741–747.
24.
Javier MendicuteJIrigoyenCRuizM, et al. Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery. J Cataract Refract Surg2009; 35: 451–458.
25.
QammarAMullaneyP.Paired opposite clear corneal incisions to correct preexisting astigmatism in cataract patients. J Cataract Refract Surg2005; 31(6): 1167–1170.
26.
AbbeyAIdeTKymionisGD, et al. Femtosecond laser-assisted astigmatic keratotomy in naturally occurring high astigmatism. Br J Ophthalmol2009; 93(12): 1566–1569.
27.
ChanTCYChengGPMWangZ, et al. Vector analysis of corneal astigmatism after combined femtosecond-assisted phacoemulsification and arcuate keratotomy. Am J Ophthalmol2015; 160(2): 250.e2–255.e2.
28.
LimRBorasioEIlariL.Long-term stability of keratometric astigmatism after limbal relaxing incisions. J Cataract Refract Surg2014; 40(10): 1676–1681.
29.
KaufmannCPeterJOoiK, et al. Limbal relaxing incisions versus on-axis incisions to reduce corneal astigmatism at the time of cataract surgery. J Cataract Refract Surg2005; 31(12): 2261–2265.
30.
DayACLauNMStevensJD.Nonpenetrating femtosecond laser intrastromal astigmatic keratotomy in eyes having cataract surgery. J Cataract Refract Surg2016; 42(1): 102–109.
31.
DayACStevensJD.Predictors of femtosecond laser intrastromal astigmatic keratotomy efficacy for astigmatism management in cataract surgery. J Cataract Refract Surg2016; 42(2): 251–257.
32.
RucklTDexlAKBacherneggA, et al. Femtosecond laser-assisted intrastromal arcuate keratotomy to reduce corneal astigmatism. J Cataract Refract Surg2013; 39(4): 528–538.
33.
HummelCDDiakonisVFDesaiNR, et al. Cyclorotation during femtosecond laser-assisted cataract surgery measured using iris registration. J Cataract Refract Surg2017; 43(7): 952–955.
34.
RobertsHWWaghVKSullivanDL, et al. Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery. J Cataract Refract Surg2018; 44(8): 955–963.
35.
DayACStevensJD.Stability of keratometric astigmatism after non-penetrating femtosecond laser intrastromal astigmatic keratotomy performed during laser cataract surgery. J Refract Surg2016; 32(3): 152–155.
36.
YooAYunSKimJY, et al. Femtosecond laser-assisted arcuate keratotomy versus toric IOL implantation for correcting astigmatism. J Refract Surg2015; 31(9): 574–578.
MastropasquaLTotoLMatteiPA, et al. Optical coherence tomography and 3-dimensional confocal structured imaging system-guided femtosecond laser capsulotomy versus manual continuous curvilinear capsulorhexis. J Cataract Refract Surg2014; 40(12): 2035–2043.
39.
NagyZZKranitzKTakacsAI, et al. Comparison of intraocular lens decentration parameters after femtosecond and manual capsulotomies. J Refract Surg2011; 27(8): 564–569.
40.
KranitzKTakacsAMihaltzK, et al. Femtosecond laser capsulotomy and manual continuous curvilinear capsulorrhexis parameters and their effects on intraocular lens centration. J Refract Surg2011; 27(8): 558–563.
41.
KranitzKMihaltzKSandorGL, et al. Intraocular lens tilt and decentration measured by Scheimpflug camera following manual or femtosecond laser-created continuous circular capsulotomy. J Refract Surg2012; 28(4): 259–263.
42.
FindlOHirnschallNDraschlP, et al. Effect of manual capsulorhexis size and position on intraocular lens tilt, centration, and axial position. J Cataract Refract Surg2017; 43(7): 902–908.
43.
LawlessMBaliSJHodgeC, et al. Outcomes of femtosecond laser cataract surgery with a diffractive multifocal intraocular lens. J Refract Surg2012; 28: 859–864.
44.
Mursch-EdlmayrASBolzMLuftN, et al. Intraindividual comparison between femtosecond laser-assisted and conventional cataract surgery. J Cataract Refract Surg2017; 43(2): 215–222.
45.
PanthierCCostantiniFRigal-SastourneJC, et al. Change of capsulotomy over 1 year in femtosecond laser-assisted cataract surgery and its impact on visual quality. J Refract Surg2017; 33(1): 44–49.
AbellRGDarian-SmithEKanJB, et al. Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: outcomes and safety in more than 4000 cases at a single center. J Cataract Refract Surg2015; 41(1): 47–52.
48.
DayACGartryDSMaurinoV, et al. Efficacy of anterior capsulotomy creation in femtosecond laser-assisted cataract surgery. J Cataract Refract Surg2014; 40(12): 2031–2034.
49.
RobertsHWWaghVKSullivanDL, et al. A randomized controlled trial comparing femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery. J Cataract Refract Surg2019; 45(1): 11–20.
50.
MastropasquaLTotoLCaliennoR, et al. Scanning electron microscopy evaluation of capsulorhexis in femtosecond laser-assisted cataract surgery. J Cataract Refract Surg2013; 39(10): 1581–1586.
51.
Al HarthiKAl ShahwanSAl TowerkiA, et al. Comparison of the anterior capsulotomy edge created by manual capsulorhexis and 2 femtosecond laser platforms: scanning electron microscopy study. J Cataract Refract Surg2014; 40(12): 2106–2112.
52.
SerraoSLombardoGDesiderioG, et al. Analysis of femtosecond laser assisted capsulotomy cutting edges and manual capsulorhexis using environmental scanning electron microscopy. J Ophthalmol2014; 2014: 520713–520717.
53.
LuaMROertlePCamenzindL, et al. Superior rim stability of the lens capsule following manual over femtosecond laser capsulotomy the lens capsule after manual or laser capsulotomy. Invest Ophthalmol Vis Sci2016; 57: 2839–2849.
54.
AuffarthG.Comparison of the maximum applicable stretch force after femtosecond laser–assisted and manual anterior capsulotomy. J Cataract Refract Surg2013; 39(1): 105–109.
55.
SandorGLKissZBocskaiZI, et al. Comparison of the mechanical properties of the anterior lens capsule following manual capsulorhexis and femtosecond laser capsulotomy. J Refract Surg2014; 30(10): 660–664.
56.
ChanTPattamattaUButlinM, et al. Intereye comparison of femtosecond laser-assisted cataract surgery capsulotomy and manual capsulorhexis edge and strength. J Cataract Refract Surg2017; 43: 480–485.
57.
ChangDFMamalisNWernerL.Precision pulse capsulotomy: preclinical safety and performance of a new capsulotomy technology. Ophthalmology2016; 123(2): 255–264.
58.
HooshmandJAbellRGAllenP, et al. Thermal capsulotomy: initial clinical experience, intraoperative performance, safety, and early postoperative outcomes of precision pulse capsulotomy technology. J Cataract Refract Surg2018; 44(3): 355–361.
59.
StodulkaPPackardRMordauntD. Efficacy and safety of a new selective laser device to create anterior capsulotomies in cataract patients. J Cataract Refract Surg; 45(5): 601–607.
60.
DayaSCheeSPTiSE, et al. Comparison of anterior capsulotomy techniques: continuous curvilinear capsulorhexis, femtosecond laser-assisted capsulotomy and selective laser capsulotomy. Br J Ophthalmol. Epub ahead of print 4 April 2019. DOI: 10.1136/bjophthalmol-2018-313421.
61.
KovacsIKranitzKSandorGL, et al. The effect of femtosecond laser capsulotomy on the development of posterior capsule opacification. J Refract Surg2014; 30(3): 154–158.
62.
FindlOBuehlWBauerP, et al. Interventions for preventing posterior capsule opacification. Cochrane Database Syst Rev2010; 97: 669–663.
63.
TranDBVargasVPotvinR.Neodymium:YAG capsulotomy rates associated with femtosecond laser-assisted versus manual cataract surgery. J Cataract Refract Surg2016; 42(10): 1470–1476.
64.
MuranoNIshizakiMSatoS, et al. Corneal endothelial cell damage by free radicals associated with ultrasound oscillation. Arch Ophthalmol2008; 126(6): 816–821.
65.
ShinYJNishiYEnglerC, et al. The effect of phacoemulsification energy on the redox state of cultured human corneal endothelial cells. Arch Ophthalmol2009; 127(4): 435–441.
66.
Conrad-HengererIHengererFHSchultzT, et al. Effect of femtosecond laser fragmentation on effective phacoemulsification time in cataract surgery. J Refract Surg2012; 28(12): 879–883.
67.
Conrad-HengererIHengererFHSchultzT, et al. Effect of femtosecond laser fragmentation of the nucleus with different softening grid sizes on effective phaco time in cataract surgery. J Cataract Refract Surg2012; 38(11): 1888–1894.
68.
AhnDSHanSYLeeKH.Comparison of effective phacoemulsification time between femtosecond laser-assisted cataract surgery and conventional cataract surgery. J Korean Ophthalmol Soc2016; 57: 236–242.
69.
MayerWJKlaprothOKHengererFH, et al. Impact of crystalline lens opacification on effective phacoemulsification time in femtosecond laser-assisted cataract surgery. Am J Ophthalmol2014; 157: 426–432.
70.
Al-KhateebGShajariMVunnavaK, et al. Impact of lens densitometry on phacoemulsification parameters and usage of ultrasound energy in femtosecond laser-assisted lens surgery. Can J Ophthalmol2017; 52(4): 331–337.
71.
AbellRGKerrNMVoteBJ.Toward zero effective phacoemulsification time using femtosecond laser pretreatment. Ophthalmology2013; 120(5): 942–948.
72.
PalankerDVBlumenkranzMSAndersenD, et al. Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography. Sci Transl Med2010; 2(58): 58ra85.
73.
HidaWTTzelikisPFVilarC, et al. Outcomes study between femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery using an active fluidics system. Clin Ophthalmol2017; 11: 1735–1739.
74.
HuseynovaTMitaMCorpuzCCC, et al. Evaluating the different laser fragmentation patterns used in laser cataract surgeries in terms of effective phacoemulsification time and power. Clin Ophthalmol2015; 9: 2067–2071.
75.
Conrad-HengererIAl JuburiMSchultzT, et al. Corneal endothelial cell loss and corneal thickness in conventional compared with femtosecond laser-assisted cataract surgery: three-month follow-up. J Cataract Refract Surg2013; 39(9): 1307–1313.
76.
KrarupTHolmLMLa CourM, et al. Endothelial cell loss and refractive predictability in femtosecond laser-assisted cataract surgery compared with conventional cataract surgery. Acta Ophthalmol2014; 92(7): 617–622.
77.
AbellRGKerrNMHowieAR, et al. Effect of femtosecond laser-assisted cataract surgery on the corneal endothelium. J Cataract Refract Surg2014; 40(11): 1777–1783.
78.
DzhaberDMustafaOAlsalehF, et al. Comparison of changes in corneal endothelial cell density and central corneal thickness between conventional and femtosecond laser-assisted cataract surgery: a randomised, controlled clinical trial. Br J Ophthalmol. Epub ahead of print 1 January 2019. DOI: 10.1136/bjophthalmol-2018-313723.
79.
DayACGoreDMBunceC, et al. Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery. Cochrane Database Syst Rev2016; 7: CD010735.
80.
ChenXYuYSongX, et al. Clinical outcomes of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery for hard nuclear cataracts. J Cataract Refract Surg2017; 43(4): 486–491.
81.
ZhuDCShahPFeuerWJ, et al. Outcomes of conventional phacoemulsification versus femtosecond laser-assisted cataract surgery in eyes with Fuchs endothelial corneal dystrophy. J Cataract Refract Surg2018; 44(5): 534–540.
82.
SchultzTJoachimSCNoristaniR, et al. Greater vertical spot spacing to improve femtosecond laser capsulotomy quality. J Cataract Refract Surg2017; 43(3): 353–357.
83.
Conrad-HengererIHengererFHJoachimSC, et al. Femtosecond laser-assisted cataract surgery in intumescent white cataracts. J Cataract Refract Surg2014; 40(1):44–50.
84.
TitiyalJSKaurMSinghA, et al. Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract. Clin Ophthalmol2016; 10: 1357–1364.
85.
BarnesACRothAS.Femtosecond laser-assisted cataract surgery in anterior lenticonus due to Alport syndrome. Am J Ophthalmol2017; 6: 64–66.
SchweitzerCTellouckLGaboriauT, et al. Anterior capsule contraction treated by femtosecond laser capsulotomy. J Refract Surg2015; 31(3): 202–204.
88.
GertenGSchultzMOberheideU.Treating capsule contraction syndrome with a femtosecond laser. J Cataract Refract Surg2016; 42(9): 1255–1261.
89.
IbarzMMDRodriguez-PratsJLTanaP.Femtosecond laser-assisted capsulotomy for treatment of bilateral anterior capsule contraction. J Cataract Refract Surg2017; 43(2): 289–292.
90.
NoristaniRSchultzTDickHB.Femtosecond laser-assisted cataract surgery after radial keratotomy. J Refract Surg2016; 32(6): 426–428.
91.
CheeS-PWongMHYJapA.Management of severely subluxated cataracts using femtosecond laser–assisted cataract surgery. Am J Ophthalmol2017; 173: 7–15.
92.
AnisimovaNSMalyuginBEArbisserLB, et al. Femtosecond laser-assisted intraocular lens fragmentation: low energy transection. J Refract Surg2017; 33(9): 646–648.
93.
LeeC-YChaoS-CSunC-C, et al. Femtosecond laser-assisted cataract surgery in patients with phakic intraocular lenses and low endothelial cell counts: a case report. BMC Ophthalmol2017; 17(1): 180.
94.
Haeussler-SinanginYSchultzTHoltmannE, et al. Primary posterior capsulotomy in femtosecond laser-assisted cataract surgery: in vivo spectral-domain optical coherence tomography study. J Cataract Refract Surg2016; 42(9): 1339–1344.
95.
SchojaiMSchultzTHaeussler-SinanginY, et al. Safety of femtosecond laser-assisted primary posterior capsulotomy immediately after cataract surgery. J Cataract Refract Surg2017; 43(9): 1171–1176.
96.
BordinPVizzariG.A new surgical technique in congenital cataract with femtosecond laser. J Ophthalmol2016; 1: 1–4.
97.
PopovicMCampos-MollerXSchlenkerMB, et al. Efficacy and safety of femtosecond laser-assisted cataract surgery compared with manual cataract surgery: a meta-analysis of 14 567 Eyes. Ophthalmology2016; 123(10): 2113–2126.
98.
Conrad-HengererIAl SheikhMHengererFH, et al. Comparison of visual recovery and refractive stability between femtosecond laser-assisted cataract surgery and standard phacoemulsification: six-month follow-up. J Cataract Refract Surg2015; 41(7): 1356–1364.
99.
ScottWJSTauberSTGesslerJAG, et al. Comparison of vitreous loss rates between manual phacoemulsification and femtosecond laser-assisted cataract surgery. J Cataract Refract Surg2016; 42(7): 1003–1008.
100.
ManningSBarryPHenryY, et al. Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery. J Cataract Refract Surg2016; 42(12): 1779–1790.
101.
SchweitzerC. Evidence from the French FEMCAT study. In: European Society of Cataract and Refractive Surgeons meeting, Lisbon, 7–11 October.
102.
BozkurtTKMillerKM.Suprachoroidal hemorrhage during Femtosecond Laser Assisted Cataract Surgery. Am J Ophthalmol Case Rep2016; 4: 45–46.
103.
SchojaiMSchultzTBurkhard DickH.Capsule-fixated intraocular lens implantation in small pupil cases. J Refract Surg2017; 33(8): 568–570.
104.
Gil-CazorlaRNarooSBerrowE, et al. Clinical outcomes of a novel IOL design for Femtosecond laser assisted cataract surgery. Contact Lens Anterior Eye2018; 41: S51.
105.
NguyenJWernerLLudlowJ, et al. Intraocular lens power adjustment by a femtosecond laser. J Cataract Refract Surg2018; 44: 226–230.
106.
BilleJFEngelhardtJVolppH-R, et al. Chemical basis for alteration of an intraocular lens using a femtosecond laser. Biomed Opt Express2017; 8(3): 1390–1404.
107.
SahlerRBilleJFEnrightS, et al. Creation of a refractive lens within an existing intraocular lens using a femtosecond laser. J Cataract Refract Surg2016; 42(8): 1207–1215.
108.
WernerLMDLudlowJNguyenJ, et al. Biocompatibility of intraocular lens power adjustment using a femtosecond laser in a rabbit model. J Cataract Refract Surg2017; 43(8): 1100–1106.
LauFSWaldieAMSpencerSKR, et al. Primary femtosecond laser posterior capsulotomy: without clinical outcomes, caution should be exercised. J Cataract Refract Surg2017; 43: 1237.
112.
WertheimerCMShajariMKohnenT, et al. Comparison of fibrotic response in the human lens capsular bag after femtosecond laser-assisted cataract surgery and conventional phacoemulsification. J Cataract Refract Surg2018; 44(6): 750–755.
113.
ChenXXiaoWYeS, et al. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials. Sci Rep2015; 5: 13123.
114.
DayACBurrJMBunceC, et al. Randomised, single-masked non-inferiority trial of femtosecond laser-assisted versus manual phacoemulsification cataract surgery for adults with visually significant cataract: the FACT trial protocol. BMJ Open2015; 5(11): e010381.
AbellRGVoteBJ.Cost-effectiveness of femtosecond laser-assisted cataract surgery versus phacoemulsification cataract surgery. Ophthalmology2014; 121: 10–16.
117.
BaliSJHodgeCLawlessM, et al. Early experience with the femtosecond laser for cataract surgery. Ophthalmology2012; 119: 891–899.
118.
LubahnJGDonaldsonKECulbertsonWW, et al. Operating times of experienced cataract surgeons beginning femtosecond laser-assisted cataract surgery. J Cataract Refract Surg2014; 40(11): 1773–1776.
119.
GrewalDSDalalRRJunS, et al. Impact of the learning curve on intraoperative surgical time in femtosecond laser-assisted cataract surgery. J Refract Surg2016; 32(5): 311–317.
120.
RobertsHWNiMZO’BrartDPS. Financial modelling of femtosecond laser-assisted cataract surgery within the National Health Service using a ‘hub and spoke’ model for the delivery of high-volume cataract surgery. BMJ Open2017; 7(3): e013616.
121.
RobertsHWWaghVKMullensIJM, et al. Evaluation of a hub-and-spoke model for the delivery of femtosecond laser-assisted cataract surgery within the context of a large randomised controlled trial. Br J Ophthalmol2018; 102(11): 1556–1563.
