In brief

  • FLACS required less ultrasound energy.
  • Day-one vision recovered faster, with less corneal thickening and inflammation.
  • At one and three months, vision, refraction and endothelial cell loss did not differ.

How the methods were compared

The randomized trial included 113 patients with age-related cataract: 56 received FLACS and 57 conventional phacoemulsification. Allocation was concealed and stratified by nucleus hardness, care was standardized, and outcomes were assessed while masked. Follow-up occurred at day one, week one, month one and month three.

Where FLACS helped FLACS reduced cumulative dissipated energy and effective phaco time. The clinically visible advantage was concentrated in the first postoperative day.

What it means

Laser prefragmentation may reduce transient corneal stress and inflammation. Patients may have a smoother first day without better final vision. That early benefit should be balanced against cost, an additional procedural stage and equipment access.

Limitations

Follow-up ended at three months. The sample was too small to compare rare complications, so no statistical difference does not establish equal safety. Results also depend on platform, nucleus density and surgeon experience and should not be generalized automatically to complex cataracts.