<p>Cystoid Macular Edema Following Cataract Surgery with Low-Energy Femtosecond Laser versus Conventional Phacoemulsification</p>

Abstract

To compare postoperative changes in central subfield macular thickness (CSMT) and prevalence of cystoid macular edema (CME) in patients undergoing cataract surgery with low-energy femtosecond laser versus standard phacoemulsification. Design: This was a retrospective comparative real-world study. Methods: Postoperative data of 252 eyes of 165 patients were collected: 138 eyes received low-energy femtosecond laser-assisted cataract surgery (FLACS) and 114 eyes underwent conventional phacoemulsification cataract surgery (CPCS). Postoperative changes in CSMT and prevalence of CME were compared between the two groups. Results: There was a significant increase in mean CSMT from preoperative to postoperative values at 2.5 months in both the FLACS and CPCS group (p<0.001). Mean change (preoperation to 2.5 months postoperation) in CSMT was 6.2±11.5 µm in the FLACS group and 7.3±26.6 µm in the CPCS group, which was statistically significant but clinically not relevant. Comparison of mean changes in CSMT (preoperation to 2.5 months postoperation) between the FLACS and CPCS groups revealed no significant differences. The rate of pseudophakic CME (PCME) development was lower in the FLACS group (1.4%) than the CPCS group (4.4%; p=0.247). When using PREMED criteria to define clinically significant PCME, only 0.7% patients in the FLACS group and 1.8% in the CPCS group showed development of clinically significant PCME (p=0.586). Conclusion: The mean change in CSMT and occurrence of postoperative CME was lower in the low-energy FLACS group than the standard-phacoemulsification group; however, the difference was not statistically significant.

Dexamethasone intravitreal implant along with femtosecond laser assisted cataract surgery in patients with diabetic macular edema and cataract

“…44 Low-energy femtosecond laser that we used, has been reported to produce no meaningful increase in prostaglandin levels in the aqueous humor. 45 Recently, Van Nuffel et al 23 reported that FLACS with low-energy femtosecond laser and conventional surgery were comparable with regard to the changes in mean CRT and the occurrence of macular edema, although the low-energy FLACS induced a trend toward lower rates of macular edema.…”

“…19,21 In contrast, low-energy femtosecond lasers have been associated with less inflammatory response and collateral ocular damage. 22,23…”

Randomized Controlled Trial Comparing 1-Year Outcomes of Low-Energy Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification

“…Meta-analysis data have shown that there was no significant difference in the incidence of CME between FLACS and conventional phacoemulsification (23), which is in alignment with our study. Nuffel et al further evaluated the changes in the central subfield macular thickness in low-energy FLACS vs. conventional surgery and reported no statistically significant difference (37).…”

Management of inflammation after the cataract surgery

“…It is yet unknown what clinical effect inflammation caused by FLACS has because it is reported that cases done with femtosecond laser does not result in greater PCME when compared with conventional phacoemulsification [26,27 ▪ ,28].…”