Visual and refractive outcomes and complications in femtosecond laser-assisted versus conventional phacoemulsification cataract surgery: findings from a randomised, controlled clinical trial

Abstract

Background/aimTo compare visual and refractive outcomes, changes in intraocular pressure (IOP), and complications of femtosecond laser-assisted cataract surgery (FLACS) to conventional phacoemulsification surgery (CPS) in paired eyes from the same patients.MethodsThis is a secondary analysis of an intraindividual, randomised, controlled clinical trial including 110 paired eyes from 55 patients that were randomised into either FLACS or CPS groups. Outcomes were recorded at baseline and postoperatively during a 3-month follow-up period.ResultsUncorrected distance visual acuity and corrected distance visual acuity were similar between FLACS and CPS over the follow-up period (p>0.05). The mean absolute refractive error was not significantly different between the two groups at postoperative month 1 (POM1) (0.3±0.2 D in FLACS vs 0.4±0.3 D in CPS, p=0.18) and month 3 (POM3) (0.3±0.3 D in FLACS vs 0.3±0.3 D in CPS, p=0.71). IOP was statistically higher in the FLACS group on postoperative day 1 (20.6±5.7 mm Hg for FLACS and 18.0±4.9 mm Hg for CPS, p=0.01). However, it was similar between the two groups subsequently (p>0.05). Intraoperatively, one case of posterior capsular block syndrome was observed in the FLACS group. Postoperatively, one case of newly developed glaucoma was observed in the FLACS group and one case of retinal tears in the CPS group.ConclusionThe 3-month postoperative refractive and visual outcomes were comparable between FLACS and CPS in paired eyes from the same patients. Complication rate was low in the study population.

Comparison of endothelial cell loss in diabetic patients after conventional phacoemulsification and femtosecond laser-assisted cataract surgery

“…Our results did not show statistically significant difference in postoperative visual acuity between the two techniques over the follow-up period. These findings are consistent with the majority of published studies that have not found significant postoperative benefit of FLACS over conventional surgery [ 24 , 25 ].…”

Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification Surgery: Clinical Outcomes with EDOF IOLs

“…The complex optical design of the EDOF IOL showed higher sensitivity to IOL tilt and decentration, which might lead to larger HOAs, diminishing the effect and satisfaction of EDOF IOL implantation [ 23 , 24 ]. FLACS has been reported to achieve unparalleled accuracy and precision in the size, shape, and position of capsulorhexis, resulting in higher refractive predictability, less corneal edema, and less IOL tilt or decentration [ 5 , 6 , 7 , 8 ]. To our knowledge, no previous study has comprehensively compared the clinical outcomes between FLACS and CPS with the implantation of an EDOF IOL.…”

“…In recent years, the clinical application of the femtosecond laser has led to new developments for cataract surgery. Combined with computer-controlled optical delivery systems, this technique has the advantages of more precise circularity and adjustability of the capsulorhexis diameter, nucleus fragmentation of lenses, arcuate keratotomy, and multi-plane self-sealing incision creation without collateral damage to surrounding tissues [ 5 , 6 , 7 , 8 ]. A more precise capsulotomy prior to the implantation of aspheric or multifocal IOLs contributes to better visual results, as the tilt or decentration of the IOL can led to higher asymmetrical aberrations [ 9 , 10 , 11 , 12 , 13 , 14 ].…”

Two-Year Follow-Up of Clinical Efficacy of Femtosecond Laser, Modified Capsular Tension Ring, and Iris Hook-Assisted Surgical Treatment of Lens Subluxation in Patients with Elevated Intraocular Pressure

“…Our results indicate that the anterior vitreous has less influence on CCC, as shown in a prior study [ 21 ]. Notably, the IOP could be elevated due to the docking procedure during the femtosecond laser process and presumably returns to the normal range within a short period of time [ 22 ].…”