Macular morphology assessed by optical coherence tomography image segmentation after femtosecond laser–assisted and standard cataract surgery

Abstract

After cataract surgery, macular edema was detectable mainly in the outer nuclear layer in both groups but was significantly less using the femtosecond laser platform.

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

“…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. 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 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.…”

Femtosecond Laser-assisted Cataract Surgery

“…47 This same study also showed significantly lower macular thickness in the inner retinal ring in the FLACS group after adjusting for age and preoperative thickness across the time course, compared with a control group. 47 Adverse effects have been reported. In a recent study, five eyes (two in the FLACS group; three in the control group) developed significant cystoid macular edema (CME) following cataract surgery.…”

“…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. 47 This same study also showed significantly lower macular thickness in the inner retinal ring in the FLACS group after adjusting for age and preoperative thickness across the time course, compared with a control group.…”

“…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. 47 This same study also showed significantly lower macular thickness in the inner retinal ring in the FLACS group after adjusting for age and preoperative thickness across the time course, compared with a control group. 47 Adverse effects have been reported.…”