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Add to this “no room for improvement” scenario the fact that the price
of a FLACS system (roughly $500,000)
keeps it beyond the reach of newer and
less-skilled practitioners (59% of
respondents to the ASCRS sur-
vey considered FLACS technolo-
gy too costly), and the fog begins
to clear. Especially when a cou-
ple of large research studies (
studies that many contend were poorly designed, and therefore generated skewed
results) support the “no measurable benefit” conclusion.
In other words, the very practitioners
most likely to benefit from FLACS are
those least likely to have tried it—and are
hearing from leaders in the field that it’s
not worthwhile. Eric Donnenfeld, MD,
Clinical Professor of Ophthalmology, New
York University Medical Center, said a year
ago that while FLACS may not provide an
advantage for the most skilled surgeons,
it can definitely enhance outcomes for av-
erage surgeons, and will ultimately allow
more doctors to do a good job of perform-
ing refractive cataract surgery. 3 Today, he
stands by that comment “more than ever.”
The way out
So, how do we get out of this mess? With
smaller, lower-cost instruments that pro-
vide greater efficiency than most of today’s
options, says Rosa Braga-Mele, MD, MEd,
FRCSC, Professor of Ophthalmology at
the University of Toronto (Canada)—who,
Instrumentation developers are listen-
ing, and although some were not able
to go on record with their comments,
these priorities seem to align with their
plans. In the competitive market that
is FLACS, Hadi Srass, Project Head
III, Surgical Instrumentation, R&D at
Alcon LenSx—the largest supplier of
FLACS systems—was unable to de-
scribe specific goals. But he did
state that Alcon maintains
close relationships with us-
ers and that the company’s
development team is targeting issues important to
surgeons. He also explained
that Alcon considers a few things—
including phaco—core to the company,
and as a leading provider of FLACS
systems, is prioritizing femtosecond
technology as well. He also noted that
advancement in technology is to be expected, especially for an application just
FIGURE 2.
Do handheld
mechanical tools like
Ian Tech’s miLoop have as
much potential as femtosecond
laser-assisted cataract surgery
(FLACS) systems?
