الفهرس 
CATARACTOnly 14 pages are availabe for public view
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Abstract
Cataract is characterized with opacity of the crystalline
lens that can markedly limit the routine activities of patients
such as reading, writing, walking and in the long run reduce the
quality of life. Cataract is the main cause of preventable
blindness. Despite some modern advances in the field of
cataract impending drug treatments, surgical treatment is still
known to be the most actual treatment option.
Cataract surgery is the most frequently performed
ophthalmic operation in the world. One of the most critical
steps in cataract removal is creation of acontinuous round
opening in the lens anterior capsule named capsulorhexis. CCC
is considered to be the usual method of performing anterior
capsulotomy. The size, shape and centration of capsulorhexis
are key determinants of positioning IOL and eventually visual
outcome. Too small or too large capsulorhexis can cause
several problems, including IOL decentration, hyperopic shift,
PCO , etc. CCC is a manual procedure and even with skilled
surgeons the size, shape and centration of capsulorhexis can be
variable depending on the type and maturity of the cataract.
Femtosecond is the latest laser platform which has
revolutionised cataract surgery by minimising surgeon
dependent variations of capsulorhexis. Now we can modify the
size, shape and centration of capsulorhexis depending upon
type of intraocular lens and nuclear sclerosis. Femtosecond lasers (FSL) use as shorter pulse time as (10-15) seconds, thus
further decreasing the energy output for a given effect without
the collateral tissue damage. Therefore, FSL assisted surgery
proved to be more precise and accurate in terms of producing
predictable anterior capsulotomy that led to desired positioning
of intra-ocular lens. There were certain reports that showed
higher rate of anterior capsule tear with the use of FSL as
compared with conventional CCC.
The current study was performed to evaluate features of
capsulotomies obtained during femtosecond laser–assisted
cataract surgery (FLACS) and compare them with CCCs
obtained using a standard manual technique and to determine
whether FLACS is safer, effective and better or not.
This meta-analysis was conducted from 1/1/2015 to
31/7/2018. Literature search on PubMed was done to identify
randomised controlled trials and comparative studies MedCalc
ver. 18.2 (MedCalc, Ostend, Belgium) was used for data
analysis.
Of the 17 articles included, there were 3(18%)
randomised controlled trials and 14(82%) comparative study.
The meta-analysis was based on a total of 18558 eyes. Of them,
9442 (50.88%) underwent femtosecond laser-assisted
capsulotomy and 9116 (49.12%) underwent manual continuous
curvilinear capsulorrhexis. Comparative study between the 2
groups revealed; highly significant increase in better IOL centration; in FLACS group; compared to CCC group; with
highly significant statistical difference (p < 0.01).
Comparative study between the 2 groups revealed nonsignificant
difference as regards capsulotomy diameter (p > 0.05).
Comparative study between the 2 groups revealed nonsignificant
difference as regards CDVA, UDVA and MAE (p > 0.05)
As regards the complications; fixed-effect model showed
highly significant increase in complications rate in FLACS
group; but random-effects model showed non-significant
difference between the 2 groups (p < 0.001, p > 0.05
respectively).