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Femtosecond Laser Technology Not Add Benefit: 2016
In an Editorial by Esteemed ophthalmologist Randy Olson MD University of Utah Dr. Olson concludes that additional benefit to standard cataract surgery is unproven with femtosecond laser technology. This is a quote from it:
"So we have Femtosecond Laser Assisted Cataract Surgery, this new technology that has shown steady improvement and that many support. Yet others feel its advantages are either clinically unimportant or lack convincing clinical studies to support uniform utilization in the face of increased expense and time. While this wave is far from peaking, it would seem that supporters of FLACS are remiss in not providing more robust comparative studies, especially looking at any complication differences in the very difficult cataract categories. Although the jury may be out, I think many cataract surgeons are underwhelmed with FLACS supplanting phaco alone as today's dominant cataract removal procedure. That said, future studies and/or technology advancement may change this view."
"So we have Femtosecond Laser Assisted Cataract Surgery, this new technology that has shown steady improvement and that many support. Yet others feel its advantages are either clinically unimportant or lack convincing clinical studies to support uniform utilization in the face of increased expense and time. While this wave is far from peaking, it would seem that supporters of FLACS are remiss in not providing more robust comparative studies, especially looking at any complication differences in the very difficult cataract categories. Although the jury may be out, I think many cataract surgeons are underwhelmed with FLACS supplanting phaco alone as today's dominant cataract removal procedure. That said, future studies and/or technology advancement may change this view."
Be interesting to see Baylor's conclusions after their study is completed.
Dr Olson can say anything he wants in an editorial.
Hardly conclusive.
https://www.bcm.edu/news/eye/study-laser-improve-cataract-surgery
Dr Olson can say anything he wants in an editorial.
Hardly conclusive.
https://www.bcm.edu/news/eye/study-laser-improve-cataract-surgery
Thanks for your information, chazas. Wishing you smooth sailing on this as well.
2 Comments
One thing I would add for people considering this option. The femtosecond laser aparatus is extremely expensive to buy or rent and maintain. Thus practices that have this technology normally exert a lot of strong "upsell" to get patients to pay extra for the FLACS. Unless they can convince most of their patients to use the FLACS they end up taking a significant loss to practice revenue.
JCH MD
JCH MD
1 Comments
Had my eye done yesterday. As luck would have it the femto broke down and so 3 patients before me were waiting. All of which payed 1400 euro extra per eye for the FSL...
New research has shown that after 1 yr the results of those who used standard surgery over FSL have a slightly (unsure whether it was significant) better outcome.
When I discussed my options with my surgeon he said those studies were not without their limitations. I asked for studies that proof the contrary (since a supposed lack of one is not proof of the opposite). Eh...no.
Yesterday he did my surgery, outcome today (early days) are that the lens is perfectly centered and everything is fine. I have the Symfony with EDOF btw.
I strongly feel the upselling is indeed a result of the simple return on investment with this apparatus.
New research has shown that after 1 yr the results of those who used standard surgery over FSL have a slightly (unsure whether it was significant) better outcome.
When I discussed my options with my surgeon he said those studies were not without their limitations. I asked for studies that proof the contrary (since a supposed lack of one is not proof of the opposite). Eh...no.
Yesterday he did my surgery, outcome today (early days) are that the lens is perfectly centered and everything is fine. I have the Symfony with EDOF btw.
I strongly feel the upselling is indeed a result of the simple return on investment with this apparatus.
I just had my second cataract extraction yesterday. I went back and forth on the use of the laser, but in the end I decided for it. The extra cost wasn't a deslbreaker, on balance my opthamologist preferred the laser assisted procedure, and given my history of issues with the other eye I decided that even a small chance of extra accuracy in iol power selection and placement was worth it to me.
1 Comments
We have gone dispassionately through all the published statistics and decided as a group it is not worth it for either our patients or our practice. Given the cost or purchase/rent/maintain those practices that have it exert strong upsell to all their patients to 'buy up".
Sorry title was cut down: reference American Journal of Ophthalmology May 2016 Volume 165 Page Xii On my blog I have posted a link.
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