Comparative analysis of the performance of two different platforms for femtosecond laser-assisted cataract surgery

PURPOSE To analyze and compare the intraoperative and postoperative outcomes of cataract surgery performed with two different femtosecond laser platforms. METHODS Randomized controlled prospective intraindividual comparative study including 90 eyes of 45 patients aged between 61 and 86 years. All eyes underwent bilateral cataract surgery assisted with femtosecond laser technology. Eyes were randomized to one of two different femtosecond laser platforms: Catalys Precision system (Abbott Medical Optics Inc., Santa Ana, CA, USA) (Catalys group), and LenSx system (Alcon-LenSx Inc., Aliso Viejo, CA, USA) (LenSx group). Several intraoperative parameters and changes in corrected distance visual acuity and corneal endothelial density were evaluated and compared. RESULTS The LenSx group showed a significantly higher cumulative dissipated energy and phacoemulsification power needed compared to the Catalys group (P≤0.043). Likewise, a longer patient interface preparation time, more severe perception of pressure by patient, and more cases of subconjunctival hemorrhage were found in the LenSx group (P≤0.014). A complete capsulotomy was achieved in more cases in the Catalys group compared to the LenSx group (P=0.002). Regarding corneal incisions, no statistically significant differences were found between groups (P≥0.071). The same occurred for postoperative corrected distance visual acuity (P≥0.48), endothelial cell density changes (P≥0.14), and the incidence of corneal edema or flare (P≥0.399). CONCLUSION Cataract surgery with the two evaluated femtosecond laser platforms is a safe procedure, with reduced phaco time and energy, and preservation of corneal endothelium integrity. However, both systems differ in the performance of capsulotomy and the procedure of docking, with an advantage of the Catalys over the LenSx system.