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Globally,cataract disease burden is growing due to ageing population and payors and providers are increasingly looking to improve cataract surgery efficiency to meet greater demand. The objective of this study was to collate and report evidence from efficiency studies comparing FLACS with conventional phacoemulsification surgery(CPS).
A literature search was performed (search period: 2010- Sept. 2018) in PubMed to identify published cataract procedure efficiency studies. Congress proceedings (2013-2018) from the following international congresses were also searched for evidence: annual congress of International Society for Pharmacoeconomics and Outcomes Research, annual congress of European Society of Cataract & Refractive Surgeons, and annual congress of American Society of Cataract and Refractive Surgery.
We identified 9 studies reporting efficiency of FLACS vs. CPS. Operating room time, surgery time, phacoemulsification time and number of surgeries performed over time were the most commonly reported efficiency outcomes. Total phacoemulsification time favored FLACS, surgery times with FLACS and CPS were comparable and larger number of surgeries were feasible with FLACS. Higher efficiency for FLACS compared to CPS was attributed to availability of a mobile FLACS system, experience with the system, and having parallel surgery rooms sharing a common laser room. CPS was perceived as a cheaper and less complex procedure vs. FLACS but higher surgeon satisfaction levels were reported with FLACS.
Available evidence suggests more efficient cataract surgery with attainable with FLACS compared to CPS. More evidence is needed to further validate these findings.