Effect of Femtosecond Laser Cataract Surgery on the Macula

Abstract

Results of this study suggest that femtosecond laser-assisted cataract extraction does not differ in postoperative macular thickness as compared with standard ultrasound phacoemulsification.

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

“…20 No statistically significant differences between the two groups were found in terms of foveal thickness, total macular volume, or outer macular ring thickness. 20 A subsequent study demonstrated the presence of subclinical macular oedema in eyes undergoing FLACS (n ¼ 12) and conventional surgery (n ¼ 13), predominantly in the outer nuclear layer (ONL), which comprises the photoreceptors. 68 It is thought that this macular thickening is related to inflammation mediated by prostaglandins and triggered by manipulation of the anterior segment, particularly the iris.…”

“…68 It is thought that this macular thickening is related to inflammation mediated by prostaglandins and triggered by manipulation of the anterior segment, particularly the iris. 20,68 Interestingly, the relative ONL: total retina ratio was significantly less in the FLACS group in both the inner macular ring (0.26 vs 0.28) and the outer macular ring (0.27 vs 0.29). 68 No significant difference in visual acuity was found between the two groups, but this study was limited by small numbers.…”

“…In a study comparing the macular effects of FLACS vs conventional surgery 20 This difference between the FLACS and control groups reduced after 1 month and no longer attained statistical significance, but the authors suggested that reduced subclinical oedema in the early postoperative phase could be beneficial for patients at risk of developing clinically significant cystoid macular oedema later on. 20 No statistically significant differences between the two groups were found in terms of foveal thickness, total macular volume, or outer macular ring thickness. 20 A subsequent study demonstrated the presence of subclinical macular oedema in eyes undergoing FLACS (n ¼ 12) and conventional surgery (n ¼ 13), predominantly in the outer nuclear layer (ONL), which comprises the photoreceptors.…”

“…LenSx uses a curved contact lens, which applanates the cornea and produces an IOP rise of up to 40 mm Hg. 20 OptiMedica's LiquidOptics interface has been found to generate an intraocular pressure rise of 15 mm Hg. 21 Both OptiMedica and LensAR have developed no-touch, non-applanating systems, which employ a liquid interface between the laser system and the eye.…”

Femtosecond Laser-assisted Cataract Surgery

“…45 An early study of 20 eyes suggested that FLACS does not significantly differ in postoperative macular thickness compared with standard ultrasound phacoemulsification. 46 More recently, FLACS has been associated with an increase in outer zone thickness as measured by optical coherence tomography (OCT); 45 however, several studies report superior surgical outcomes with FLACS compared with conventional phacoemulsification procedures. 47 A case-control study found retinal thickening in both groups at 4 and 8 weeks postoperatively, but a lower degree of swelling in the outer nuclear layer after FLACS compared with ultrasound phacoemulsification.…”