Femtosecond Laser-Assisted Cataract Surgery (FLACS) is a form of cataract surgery that uses a precise femtosecond laser to perform key steps of the procedure. FLACS automate several parts of the surgery with computer-guided laser precision.
How does FLACS work?
- Measurements of eyes – The laser system captures detailed, 3D images of the eye to plan the incisions pattern prior to surgery.
- Laser Application – The femtosecond laser creates tiny, precise incisions in the cornea and performs a circular capsulotomy on the lens capsule. It also fragments the cataract.
- Lens Removal – The surgeon removes the pre-cut disc from the capsule's front side in the operating room. The small fragments are subsequently divided up into smaller pieces via ultrasound energy (phacoemulsification). It is removed via a vacuum suction.
- Lens Implantation – An artificial intraocular lens (IOL) is inserted to help the patient regain vision.
- Recovery – Most patients notice visual improvement within a few days, with complete recovery in a few weeks.
FLACS vs Conventional Cataract Surgery
During conventional cataract surgery, these steps are executed manually by the surgeon with precise tools. This technique has been refined throughout the years and still remains the most commonly utilised method worldwide. It is known for achieving good visual outcomes and has excellent safety records.
FLACS assists the surgeon by using the laser to carry out some of these steps. It adds precision and may reduce the amount of ultrasound energy used during cataract surgery.
The overall visual results between FLACS and conventional surgery are comparable when performed by an experienced surgeon. The experience and skill of the surgeon remain the most important factors that influence surgical results.
Risks and Considerations
As with any surgical procedure, FLACS carries some potential risks, such as:
- Discomfort after surgery
- Redness after surgery
- Fluctuation of vision during recovery
- Swelling of cornea or retina (rare)
- Infection (rare)
- Higher cost
While FLACS provides more accuracy, the visual outcome is highly dependent on IOL choice, corneal health, and cataract severity.
Who is Suitable for FLACS?
FLACS may be especially suitable for:
- Mature / white intumescent cataracts
- Zonular weakness
- Patients considering astigmatism-correction (toric) or multifocal lens implants
- Patients who prefer a technologically-assisted procedure
- Eyes that have specific needs anatomically, where precision is required
Patients with corneal scarring or certain eye conditions may not be good candidates. An eye examination by an ophthalmologist is essential in determining if FLACS is beneficial.
Cost of FLACS in Singapore
FLACS has a higher fee compared to conventional cataract surgery as it utilizes laser technology and equipment. Fees in Singapore could vary from S$2,000 to S$3,000 for each eye, additionally. Patients are recommended to check eligibility for insurance or Medisave claims before proceeding. For the costs of conventional cataract surgery in Singapore, you can read it here.
Summary
Conventional cataract surgery remains as gold standard as it is trusted by surgeons worldwide for its consistency in producing excellent results. FLACS represents an advancement in cataract surgery by merging laser precision with the established effectiveness of conventional phacoemulsification.
Patients should consult with an ophthalmologist to determine which option best matches their eyes and visual objectives.
