Surgeon: Time not right for integration of femtosecond cataract surgery in public sector

BASSANO DEL GRAPPA, Italy — Femtosecond laser-assisted cataract surgery has not, to date, achieved results that would justify its introduction in the public sector in Italy, according to one surgeon.

“It would bring no advantages to our public health system. Evidence of the cost-effectiveness of this procedure is lacking. Costs are exorbitantly high, and clinical quality improvements are not yet significant compared to the results of conventional phaco. These parameters need to change before we even discuss its introduction into public hospitals,” Alessandro Galan, MD, told Ocular Surgery News at the Bassano Ophthalmology Meeting.

Alessandro
Galan

At present, the femtosecond laser is “a very refined capsulotomy system, which cannot even be used in all cases,” he said.

An upgrade of the technology that allows nucleus liquefaction with all kinds of cataracts is needed.

“At that point, when we’ll be able to aspirate all kinds of cataracts, from soft to very hard nuclei, we’ll have some real benefit from the technique,” he said.

Galan noted that his point of view is not that of a skeptic and said he strongly believes in this technology. However, he does not agree with the strong marketing push femtosecond laser-assisted cataract surgery has received, in his opinion, “quite prematurely.”

“Manufacturers are working hard at improving this technology. This will undoubtedly lead to new advances, but until then, we, in the public sector, should stay a step behind to wait and see,” he said.

A rigorous process called health technology assessment is necessary to evaluate whether the use of femtosecond lasers may bring significant clinical advantages in comparison to conventional phacoemulsification.

“I believe no positive impact on public health can be demonstrated at present,” Galan said. – by Michela Cimberle

Disclosure: Galan reports no relevant financial disclosures.