FLACS vs Phaco in Shallow Anterior Chamber
Condition: Cataract Surgery; Shallow Anterior Chamber; Phacoemulsification
MeSH terms: Cataract
Study type: Interventional

Summary: 
      Phacoemulsification in eyes with a shallow anterior chamber (ACD < 2.2mm) presents with
      problems of safe access to the cataract and increased vulnerability of the endothelium and a
      higher tendency of complications such as descemet's detachment and iris prolapse. A shallow
      anterior chamber is also responsible for the high incidence of glaucoma and postoperative
      complications after cataract surgery. Femtosecond assisted cataract surgery has made cataract
      surgery safer and more predictable. The effective phacoemulsification time and
      intra-operative manipulation is greatly reduced in FLACS. However phacoemulsification still
      remains the most widely performed cataract surgery around the world. Post-operative outcomes
      after phacoemulsification in patients having shallow anterior chamber have been extensively
      reported in literature over the years.

      There is no head to head comparison in terms of intraoperative performance and post-operative
      outcomes between FLACS and phacoemulsification in eyes with shallow anterior chamber.

      The aim is to compare the intra-operative performance and post-operative outcomes in eyes
      undergoing femtosecond laser assisted cataract surgery versus eyes undergoing
      phacoemulsification in eyes having shallow anterior chamber.

      The study will bring an understanding on the question: Do patients undergoing Femtosecond
      laser assisted cataract surgery behave differently from those undergoing phacoemulsification?
    

Detailed description: 
      Inclusion Criteria:

        -  Age-related cataract

        -  Shallow Anterior Chamber (<2.5mm)

      Exclusion Criteria:

      -Ocular co-morbidity - corneal disorders, glaucoma, uveitis, previous ocular surgery

      Surgical Technique :

        -  Standardized, Single Surgeon

        -  2.2 mm clear corneal temporal incision

        -  FLACS Group : Capsulorhexis, Lens Fragmentation with femto laser

      The investigators will be evaluating the following parameters:

        1. Primary outcome measure Corneal thickness on day 1, week 1 and 1 month (Change in
           corneal thickness of 15% from preop. will be considered significant).

        2. Secondary outcome measures

             -  Corneal clarity -on day 1, week 1 and 1 month postoperatively

             -  Anterior chamber cells and flare (Hogan's criteria)

             -  Percentage change in endothelial cell density from preoperatively to 3 months
                postoperatively

             -  Unaided visual acuity (distance) on day 1 and 1 month.

             -  Best corrected distance visual acuity 1 month postoperatively

        3. Other Observations :

      1) Cumulative Dissipated Energy (CDE) 2) Surgical time 3) Fluid used 4) Descemets membrane
      detachment during surgery 5) Incidence of iris trauma 6) Any other intra-operative
      complications
    

Intervention name(s): Phacoemulsification Cataract SUrgery; Femtosecond Cataract Surgery
Intervention type(s): Procedure; Procedure
Intervention description(s): Phacoemulsification in eyes with shallow anterior chamber (<2.5mm depth); Femtosecond Cataract Surgery in eyes with shallow anterior chamber < 2.5mm
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: FLACS; Phaco; Shallow Anterior Chamber