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Cologne – Femtosecond laser-assisted cataract surgery and standard cataract surgery in adults are safe and equally effective. This is the result of a comparative analysis carried out by the Institute for Quality and Efficiency in Health Care (IQWiG) as part of the Topic checks remedies had ordered.
An interdisciplinary team led by the Medical University of Graz and Health Austria examined the advantages and disadvantages of the two surgical methods for cataracts.
The results of 35 studies in which approximately 7,189 eyes of 5,510 patients were treated with one of two surgical techniques were evaluated. These randomized controlled trials (RCTs) primarily looked at vision outcomes, achievement of desired vision after surgery, and complications during or after surgery.
The scientific team summarized the results of the evaluation as follows: The studies show neither advantages nor disadvantages of laser-assisted surgery compared to the standard procedure. Instead, both procedures are safe and equally effective.
The study participants’ vision generally returned to normal one month to twelve months after surgery, regardless of the surgical procedure. Quality of life also improved with both procedures. There were also no differences in terms of safety: complications such as inflammation, swelling or damage to the lens capsule occurred rarely with both procedures.
Cataract surgery is one of the most common procedures in Germany – estimates vary between 700,000 and 900,000 operations per year in Germany. Typically, fine incisions are made in the cornea and lens capsule with a scalpel, the cloudy lens is crushed using ultrasound and then suctioned out. An artificial lens is then inserted in its place.
Alternatively, some doctors offer laser-assisted surgery, in which the fine cuts in the cornea and the crushing of the lens are made not with a scalpel or ultrasound, but with a femtosecond laser. The operation must be performed with greater precision and delicacy.
The cost of a standard operation is around 900 to 1,000 euros per eye; this can be provided at the expense of the statutory health insurance (GKV). For laser surgery, the costs are around 700 to 2,100 euros. In addition, there are usually material costs, for example for disposable materials that are used during the procedure; laser surgery can usually not be performed without an additional payment.
The IQWiG emphasizes that when deciding on a surgical procedure for cataracts, objective advice and information for those affected are important for informed decision-making. This is all the more true because patients who decide to undergo laser-assisted surgery would have to bear at least some of the costs themselves. © aha/may/aerzteblatt.de