Current Ophthalmology Reports

, Volume 6, Issue 4, pp 226–232 | Cite as

Femtosecond-Assisted Cataract Surgery in Residency Training

  • Amritha D. Kanakamedala
  • Sumitra S. KhandelwalEmail author
Cataract (CE Starr and A Brissette, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cataract


Purpose of the Review

Exposure to femtosecond laser-assisted cataract surgery (FLACS) in resident education is varied and limited to a few programs at this time.

Recent Findings

Although literature has been published on FLACS in experienced surgeons, there has been limited data on FLACS in resident-performed cataract surgery. Current literature in resident-performed surgery suggests less phacoemulsification energy; however, the data on outcomes and operative time are varied.


Additional studies are needed to determine the benefits of FLACS in resident education. Regardless of the results, even minimal exposure to new technology for surgeons in training is beneficial if easily accessible by the residency program.


Cataract Cataract extraction Resident education Femtosecond 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


  1. 1.
    Nagy ZZ. New technology update: femtosecond laser in cataract surgery. Clin Ophthalmol. 2014;8:1157–67.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Linebarger EJ, Phillips Eye Institute M, MN, USA, Department of Ophthalmology SP-RMC, St. Paul, MN, USA, et al. Phacoemulsification and modern cataract surgery. Surv Ophthalmol 1999;44:123–147.Google Scholar
  3. 3.
    Yeu E, Reeves SW, Wang L, Randleman JB. Resident surgical experience with lens and corneal refractive surgery: a survey of the ASCRS Young Physicians and Residents Membership. J Cataract Refract Surg. 2013;39:279–84.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Rowden A, Krishna R. Resident cataract surgical training in United States residency programs. J Cataract Refract Surg. 2002;28:2202–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Randleman JB, Wolfe JD, Woodward M, Lynn MJ, Cherwek DH, Srivastava SK. The resident surgeon phacoemulsification learning curve. Arch Ophthalmol. 2018;125:1215–9.CrossRefGoogle Scholar
  6. 6.
    Ament CS, Henderson BA. Optimizing resident education in cataract surgery. Curr Opin Ophthalmol. 2011;22:64–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Pittner AC, Sullivan BR. Resident surgeon efficiency in femtosecond laser-assisted cataract surgery. Clin Ophthalmol. 2018;11:291–7.CrossRefGoogle Scholar
  8. 8.
    Brunin G, Khurrum K, Biggerstaff KS, Wang L, D. KD, Khandelwal SS. Outcomes of femtosecond laser-assisted cataract surgery performed by surgeons-in-training. | SpringerLink Graefes Arch Clin Exp Ophthalmol 2018;255:805–809.Google Scholar
  9. 9.
    Hou JH, Prickett AL, Cortina MS, Jain S, de la Cruz J. Safety of femtosecond laser-assisted cataract surgery performed by surgeons in training. J Refract Surg. 2018;31:69–70.CrossRefGoogle Scholar
  10. 10.
    cohen. Femtosecond laser-assisted cataract surgery in residency tra...: Curr Opin Ophthalmol 2018.Google Scholar
  11. 11.
    Nagy ZZ, Takacs AI, Filkorn T, et al. Complications of femtosecond laser–assisted cataract surgery. J Cataract Refract Surg. 2014;40:20–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Filkorn T, Kovács I, Takács Á, Horváth É, Knorz MC, Nagy ZZ. Comparison of IOL power calculation and refractive outcome after laser refractive cataract surgery with a femtosecond laser versus manual phacoemulsification. J Refract Surg. 2018;28:540–4.CrossRefGoogle Scholar
  13. 13.
    Shah RD, Sullivan BR. Resident training in femtosecond laser–assisted cataract surgery: national survey. J Cataract Refract Surg. 2018;41:1531–3.CrossRefGoogle Scholar
  14. 14.
    Manning S, Barry P, Henry Y, 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 Surg. 2016;42:1779–90.CrossRefPubMedGoogle Scholar
  15. 15.
    Bali SJ, Vision Eye Institute C, Australia, Hodge C, et al. Early experience with the femtosecond laser for cataract surgery. Ophthalmology. 2012;119:891–899.Google Scholar
  16. 16.
    Roberts T. Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases. Opthalmology. 2013;120:227–33.CrossRefGoogle Scholar
  17. 17.
    Ewe SY, Abell RG, Oakley CL, et al. A comparative cohort study of visual outcomes in femtosecond laser-assisted versus phacoemulsification cataract surgery. Ophthalmology. 2016;123:178–82.CrossRefPubMedGoogle Scholar
  18. 18.
    Oakley CL, Ewe SY, Allen PL, Vote BJ. Visual outcomes with femtosecond laser-assisted cataract surgery versus manual cataract surgery in toric IOL insertion-Oakley-2016—Clinical & Experimental Ophthalmology—Wiley Online Library. Clin Exp Ophthalmol. 2016;44.Google Scholar
  19. 19.
    Lundstrom M, Barry P, Henry Y, Rosen P, Stenevi U. Evidence-based guidelines for cataract surgery: guidelines based on data in the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. J Cataract Refract Surg. 2012;38:1086–93.CrossRefPubMedGoogle Scholar
  20. 20.
    Hosler MR, Scott IU, Kunselman AR, Wolford KR, Oltra EZ, Murray WB. Impact of resident participation in cataract surgery on operative time and cost. Ophthalmology. 2012;119:95–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Lubahn JG, Donaldson KE, Culbertson WW, Yoo SH. Operating times of experienced cataract surgeons beginning femtosecond laser–assisted cataract surgery. J Cataract Refract Surg. 2018;40:1773–6.CrossRefGoogle Scholar
  22. 22.
    Vasquez-Perez A, Simpson A, Nanavaty MA. Femtosecond laser-assisted cataract surgery in a public teaching hospital setting. BMC Ophthalmol. 2018;18:26.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Grewal DS, Dalal RR, Jun S, Chou J, Basti S. Impact of the Learning curve on intraoperative surgical time in femtosecond laser-assisted cataract surgery. J Refract Surg. 2018;32:311–7.CrossRefGoogle Scholar
  24. 24.
    Blehm C, Potvin R. Pseudophakic astigmatism reduction with femtosecond laser-assisted corneal arcuate incisions: a pilot study. Clin Ophthalmol Vol 11: Dovepress; 2017:201–207.Google Scholar
  25. 25.
    Baharozian CJ, Song C, Hatch KM, Talamo JH. A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery. Clinical Ophthalmology Vol 11: Dovepress; 2017:1841–1848.Google Scholar
  26. 26.
    Chen M, Anderson E, Hill G, Chen JJ, Patrianakos T. Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems. Clin Ophthalmol Vol 9: Dovepress; 2015:1367–1372.Google Scholar
  27. 27.
    Chang JSM, Chen IN, Chan W-M, et al. Initial evaluation of a femtosecond laser system in cataract surgery. J Cataract Refract Surg. 2014;40:29–36.CrossRefPubMedGoogle Scholar
  28. 28.
    O’Brien PD, Fitzpatrick P, Kilmartin DJ, Beatty S. Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident. J Cataract Refract Surg. 2004;30:839–43.CrossRefPubMedGoogle Scholar
  29. 29.
    Khan MS, Habib A, Ishaq M, Yaqub MA. Effect of femtosecond laser-assisted cataract surgery (FLACS) on endothelial cell count. J Coll Physicians Surg Pak. 2017;27:763–6.PubMedGoogle Scholar
  30. 30.
    Al-Mohtaseb Z, He X, Yesilirmak N, Waren D, Donaldson KE. Comparison of corneal endothelial cell loss between two femtosecond laser platforms and standard phacoemulsification. J Refract Surg. 2017;33:708–12.CrossRefPubMedGoogle Scholar
  31. 31.
    Berdahl JP, Jensen MP. The business of refractive laser assisted cataract surgery (ReLACS). Curr Opin Ophthalmol. 2014;25:62–70.CrossRefPubMedGoogle Scholar
  32. 32.
    Abell RG, Vote BJ. Cost-effectiveness of femtosecond laser-assisted cataract surgery versus phacoemulsification cataract surgery. Ophthalmology. 2014;121:10–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Amritha D. Kanakamedala
    • 1
  • Sumitra S. Khandelwal
    • 1
    • 2
    Email author
  1. 1.Baylor College of MedicineCullen Eye InstituteHoustonUSA
  2. 2.Michael E. DeBakey Veterans Affairs Medical CenterHoustonUSA

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