A One Year Longitudinal Comparative Analysis of Visual Outcomes Between Femtosecond Laser-Assisted Cataract Surgery and Standard Phacoemulsification Cataract Surgery

Abstract

Purpose To assess visual outcomes over time of femtosecond laser-assisted cataract surgery compared to standard phacoemulsification cataract surgery. Design A retrospective, single-center comparative study. Methods Patient data including demographics, ocular biometry, pre- and postoperative visual acuity, postoperative complications, primary (uncorrected distance visual acuity over time) and secondary visual outcomes (uncorrected near visual acuity, best distance visual acuity, patient complaints, satisfaction, and postoperative surgery) were gathered and statistically analyzed. Demographic differences between patients receiving femtosecond-laser assisted cataract surgery (FLACS) versus standard phacoemulsification cataract surgery (PCS) were corrected for outcome comparison. Safety, efficacy, predictability, and stability were analyzed for each procedure and compared. Results A total of 155 eyes in PCS and 143 eyes in FLACS were analyzed at 1 week, 3 months, and 1 year using odds ratio. The odds ratio of being 20/20 or better and 20/40 or better at the specified time periods were similar and statistically insignificant at all time periods analyzed except 20/20 or better for uncorrected distance visual acuity (UDVA) at 1 year (p=0.0001) and uncorrected near visual acuity (UNVA) at 1 week (p=0.02). In both cases, the odds of being 20/20 or better favored FLACS. Mean UDVA, UNVA, and best distance visual acuity (BDVA) were all similar and statistically insignificant between the two groups. Postoperative patient complaints, safety, efficacy, predictability, and stability between the two groups showed no statistical significance. Conclusion Despite the odds ratio of being 20/20 or better favoring FLACS for UDVA at 1 year and UNVA at 1 week, the mean logMAR UDVA, BDVA, and UNVA were similar and statistically insignificant between the FLACS and PCS groups at 1 week, 3 months, and 1 year. Differences in visual acuity were likely due to differences other than surgical approaches. While both FLACS and PCS are appropriate approaches to cataract surgery, one does not appear to be superior when assessing longitudinal markers for visual acuity, safety, efficacy, predictability and stability.

Comparison of short-term clinical outcomes of a diffractive trifocal intraocular lens with phacoemulsification and femtosecond laser assisted cataract surgery

“…Our study showed the significant difference of internal SR between PHACO and L Astig -FLACS group ( P < 0.05). Other MTF and SR in each group did not show the significant difference, which is consistent with existing research findings [ 16 , 25 , 26 ]. SR and MTF is an useful parameter of optical quality, which is closely associated with aberrations [ 30 ].…”

“…The femtosecond laser automated the four initial manual steps performed in cataract surgery [ 15 ] to reduce the amount of energy required for PHACO. Although there are theoretical benefits to surrounding structures from reduced ultrasonic emulsion energy, there is still debate about the effectiveness of FLACS in this regard [ 16 ].…”

Comparison of complication rates between femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery

“…FLACS involves using a femtosecond laser to assist in the initial steps of the cataract surgery, such as clear corneal incision, capsulotomy, and lens nucleus fragmentation. However, much debate remains on this topic, with studies even claiming that there is no difference in visual outcomes between both methods [3] . The Meta-analysis conducted by Chen et al [1] on 25 randomized controlled trials (RCTs) collected before November 2, 2019 compared parameters such as visual outcomes and complication rates between FLACS and CPCS.…”

Comparison of Conventional and Femtosecond Laser-Assisted Cataract Surgery Regarding Macula Behavior and Thickness

“…The only effective treatment known so far is to perform a cataract surgery. Currently, most of those interventions are performed using conventional methods, i.e., by means of phacoemulsification [2]. Cataract surgery is one of the most frequently performed surgeries worldwide.…”