OBJECTIVES:Globally, cataract disease burden is growing due to ageing population and payers and providers are increasingly looking to improve cataract surgery efficiency to meet greater demand. The objective of this study was to review and report published evidence regarding comparative efficiency of femtosecond laser assisted cataract surgery (FLACS) and manual cataract surgery (MCS). METHODS:A literature search was performed (search period: 2010 - Sept. 2018) in PubMed to identify published studies on cataract procedure efficiency. Search results were limited to English articles only. Publications reporting on comparative efficiency data between FLACS and MCS procedures in age-related cataract surgery were included. Reviews, editorials, animal studies and in-vitro studies were excluded. Additionally, congress proceedings (2013-2018) from the following international congresses were searched for evidence: annual congress of International Society for Pharmacoeconomics and Outcomes Research, annual congress of European Society of Cataract & Refractive Surgeons, and annual congress of American Society of Cataract and Refractive Surgery. RESULTS:Nine studies reporting efficiency of FLACS versus MCS (in single-center and multi-center settings) were identified. Operating room (OR) time(n=7), surgery time(n=6), phacoemulsification time(n=2) and number of surgeries performed over time(n=3) were the most commonly reported efficiency outcomes. Total phacoemulsification time favoured FLACS, surgery times with FLACS and MCS were comparable and larger number of surgeries were feasible with FLACS. Higher efficiency for FLACS versus MCS was attributed to availability of a mobile FLACS system, experience with the system, and having parallel surgery rooms sharing a common laser. CONCLUSIONS:Available evidence suggests improved efficiency is attainable with FLACS versus MCS, mainly attributed to availability of mobile FLACS system and possibility of feeding parallel surgery rooms by a common laser. Although MCS could be perceived as a cheaper and less complex procedure initially, improved procedural efficiency and higher surgeon satisfaction levels could be realized for FLACS with suitable OR flow planning.