Efectividad de la facoemulsificación versus la femtofacoemulsificación como tratamiento de la catarata senil en adultos mayores. Revisión sistemática

Abstract

Objective: To evaluate phacoemulsification's (PHACO) effectiveness versus femto-phacoemulsification (FLACS) as a surgical technique for managing senile cataracts in older adults. Methodology: A retrospective, descriptive, and qualitative systematic review was conducted. It was structured according to the PRISMA 2020 guidelines. Inclusion criteria: Publications from 2014 to 2024 in English or Spanish from indexed journals accessible via free full-text databases. The databases used were SciELO, PubMed, Scopus, Science Direct, Springer Link, Google Scholar, and Web of Science. Bias risk was evaluated using the Cochrane Review Manager 5.4.1 tool. Results: The findings were synthesized in a summary table featuring author, title, country, year, results, and objectives. Twenty-four 24 Randomized Controlled Trials (RCTs) with 5,943 participants were included. Each trial compared aspects of cataract surgery with PHACO versus FLACS, such as safety, efficacy, cost-effectiveness, endothelial cell loss, visual outcomes, and complications. Conclusions: Both PHACO and FLACS are viable surgical techniques for managing senile cataracts, with notable differences favoring FLACS in endothelial cell preservation and reduced ultrasonic energy use. However, PHACO remains more cost-effective and reveals comparable outcomes regarding complications and visual results, making it the preferred technique for most cases. Keywords: cataracts, surgery, phacoemulsification, femtosecond laser