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Resident complication rates similar for femtosecond-assisted, manual cataract surgery

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LONDON — The incorporation of femtosecond laser-assisted cataract extraction techniques into resident training does not negatively impact complication rates, a speaker here said.

“We know that novice surgeons have a higher intraoperative complication rate than experienced surgeons, and the literature demonstrates a higher complication rate in initial [femtosecond laser-assisted cataract surgery] compared to manual surgery in the hands of experienced surgeons,” Alessandra K. Intili, MD, told colleagues at the European Society of Cataract and Refractive Surgeons Congress. “What we do not know is how novice surgeons will fare with this new technology.”

Alessandra K. Intili

To answer that question, Intili and colleagues at Wills Eye Hospital, Philadelphia — where the femtosecond laser was introduced early into residency training — reviewed 97 femtosecond laser-assisted cataract surgery cases performed by residents during the course of 2 years. Complications were compared with complications in age-matched control patients who underwent manual surgery by residents.

The anterior capsule tear rate was similar in both groups, as was the rate of posterior capsular rupture, Intili said. A slightly higher number of patients experienced retained cortex in the femtosecond laser group.

Postoperatively, rates of macular edema and elevated IOP were also similar, according to Intili. There was a higher rate of persistent postoperative inflammation in the manual arm of the study that trended toward being significant, she said, but overall, there was no statistically significant difference between the groups.

“The incorporation of this femtosecond laser to our residency training program did not negatively impact our patient complication rates,” Intili said.