scholarly journals Comparison of Optical Quality and Distinct Macular Thickness in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery

2019 ◽  
Author(s):  
Yong Wang ◽  
Jinling Zhang ◽  
Miaomiao Qin ◽  
Jianguo Miao ◽  
Wei Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Optical Quality ◽  
Macular Thickness ◽  
Modulation Transfer ◽  
Distance Visual Acuity ◽  
Spatial Frequencies ◽  
Post Operation ◽  
Phacoemulsification Cataract Surgery

Abstract Background: Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery. In current research, we evaluated optical quality recovery and distinct macular thicknesschanges after FLACS and phacoemulsification cataract surgery (PCS). Methods: A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and dysfunctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions pre-operatively and1month after the surgery. Results: In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI ( p <0.0001), PSF(strehl ratio, SR) ( p= 0.027) and MTF ( p =0.028), but not intraocular pressure (IOP) ( p =0.857). The differences between pre-operation and post-operation for DLI ( p =0.031), SR ( p =0.01) and IOP ( p =0.03), but not MTF ( p =0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 ( p =0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group. In PCS group, we found the differences between pre-operation and post-operation in nasal inter macular ring thickness (NIMRT) ( p =0.03), foveal volume (FV) ( p =0.034) and average retinal thickness (ART) ( p =0.025) but not FLACS group. Conclusion: FLACSis safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast,PCS can produce macular thickness changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.

scholarly journals Comparison of Optical Quality and Distinct Macular Thickness in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery

2019 ◽  
Author(s):  
Yong Wang(Former Corresponding Author) ◽  
Jinling Zhang ◽  
Miaomiao Qin ◽  
Jianguo Miao ◽  
Wei Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Optical Quality ◽  
Macular Thickness ◽  
Modulation Transfer ◽  
Distance Visual Acuity ◽  
Spatial Frequencies ◽  
Post Operation ◽  
Phacoemulsification Cataract Surgery

Abstract Background: Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery. In current research, we evaluated optical quality recovery and distinct macular thicknesschanges after FLACS and phacoemulsification cataract surgery (PCS). Methods: A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and dysfunctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions pre-operatively and1month after the surgery. Results: In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI ( p <0.0001), PSF(strehl ratio, SR) ( p= 0.027) and MTF ( p =0.028), but not intraocular pressure (IOP) ( p =0.857). The differences between pre-operation and post-operation for DLI ( p =0.031), SR ( p =0.01) and IOP ( p =0.03), but not MTF ( p =0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 ( p =0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group. In PCS group, we found the differences between pre-operation and post-operation in nasal inter macular ring thickness (NIMRT) ( p =0.03), foveal volume (FV) ( p =0.034) and average retinal thickness (ART) ( p =0.025) but not FLACS group. Conclusion: FLACSis safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast,PCS can produce macular thickness changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.

scholarly journals Comparison of Optical Quality and Distinct Macular Thickness in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery

2020 ◽  
Author(s):  
Yong Wang ◽  
Jinling Zhang ◽  
Miaomiao Qin ◽  
Jianguo Miao ◽  
Wei Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Optical Quality ◽  
Macular Thickness ◽  
Modulation Transfer ◽  
Distance Visual Acuity ◽  
Spatial Frequencies ◽  
Post Operation ◽  
Phacoemulsification Cataract Surgery

Abstract Background: Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery (FLACS). In current research, we evaluated optical quality recovery and distinct macular thickness changes after FLACS and phacoemulsification cataract surgery (PCS). Methods: A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and dysfunctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation,1 week and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions pre-operatively and1month after the surgery. Results: In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI ( p <0.0001), PSF (strehl ratio, SR) ( p= 0.027) and MTF ( p =0.028), but not intraocular pressure (IOP) ( p =0.857). The differences between pre-operation and post-operation for DLI ( p =0.031), SR ( p =0.01) and IOP ( p =0.03), but not MTF ( p =0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 ( p =0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group at 1month. In PCS group, we found the differences between pre-operation and post-operation in nasal inter macular ring thickness (NIMRT) ( p =0.03), foveal volume (FV) ( p =0.034) and average retinal thickness (ART) ( p =0.025) but not FLACS group at 1month. Conclusion: FLACS is safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast, PCS can produce macular thickness changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.

scholarly journals Comparative Analysis of Visual Performance and Optical Quality with a Rotationally Asymmetric Multifocal Intraocular Lens and an Apodized Diffractive Multifocal Intraocular Lens

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xiao Wang ◽  
Haixia Tu ◽  
Yong Wang
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Visual Function ◽  
Optical Quality ◽  
Modulation Transfer ◽  
Multifocal Intraocular Lens ◽  
Distance Visual Acuity ◽  
Age Related ◽  
Significant Difference

Purpose. To compare the short-term visual outcomes and intraocular optical performance of a rotationally asymmetric multifocal intraocular lens (MIOL) (SBL-3, Lenstec, Inc., Christ Church, Barbados) and an apodized diffractive MIOL (the Acrysof IQ ResTOR SN6AD1, Alcon Laboratories, Inc., Fort Worth, Texas, United States). Methods. A prospective, comparative, nonrandomized, and single-center study. Sixty-eight age-related cataract patients (81 eyes) after phacoemulsification cataract surgery and in-the-bag MIOL implantation were enrolled. Thirty-eight eyes received SBL-3, and 43 eyes received SN6AD1. Ophthalmological evaluation included uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), modulation transfer function (MTF), Strehl ratio (SR), intraocular aberrations (4 mm optical zone), and defocus curve at 3 months postoperatively. The Chinese version of the visual function index-14 (VF-12-CN) and spectacle independence were assessed in all patients. Results. There was no statistically significant difference between groups in postoperative UDVA (p=0.186). Postoperative UIVA and UNVA were significantly better for the SBL-3 group than for the SN6AD1 group (p<0.01). Statistically significant differences were revealed in defocus levels from –3.50 D to −4.00 D with better visual acuities for the SBL-3 group (p<0.01). For intraocular optical quality outcomes, statistically significant differences between groups were observed in RMS of intraocular total aberrations, coma, and trefoil high-order aberrations, presenting significantly higher values of these parameters in the eyes of the SBL-3 group (p < 0.01). Statistically significant differences were revealed in the MTF values at spatial frequencies of 5 and 10 cycles/degree between groups. There were no significant differences in scores of VF-12-CN, and spectacle independence between the groups (p>0.05). Conclusions. Both MIOLs were able to successfully restore visual function after cataract surgery. SBL-3 provided better UIVA and UNVA with a wider range of intermediate vision.

Comparison of real-world treatment outcomes of femtosecond laser-assisted cataract surgery and phacoemulsification cataract surgery: A retrospective, observational study from an outpatient clinic in France

2020 ◽  
pp. 112067212092576
Author(s):  
Philippe Charles Crozafon ◽  
Christine Bouchet ◽  
Monia Zignani ◽  
Ray Griner ◽  
Samuel D Foster ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Multiple Comparisons ◽  
Posterior Capsule Opacification ◽  
Dissipated Energy ◽  
Corneal Oedema ◽  
Corrected Distance Visual Acuity ◽  
Cumulative Dissipated Energy ◽  
Phacoemulsification Cataract Surgery

Purpose: This study compared real-world safety and efficacy outcomes of cataract surgery performed with LenSx femtosecond laser-assisted cataract surgery or manual phacoemulsification cataract surgery procedures. Methods: A retrospective observational study used data from anonymised electronic medical records to compare mean cumulative dissipated energy, the proportion of eyes reaching emmetropia, mean change in best-corrected distance visual acuity and the proportion of eyes with post-surgical complications, including corneal oedema and posterior capsule opacification. Results were adjusted for multiple comparisons for primary and secondary objectives. Results: Data from 811 phacoemulsification cataract surgery and 496 femtosecond laser-assisted cataract surgery procedures were analysed. Mean cumulative dissipated energy was significantly lower for femtosecond laser-assisted cataract surgery (6.5 percent-seconds) than for phacoemulsification cataract surgery (14.3 percent-seconds; p < 0.0001) procedures. More femtosecond laser-assisted cataract surgery (81.2%) procedures achieved emmetropia (⩽ 0.5 dioptre) than did phacoemulsification cataract surgery (73.5%) procedures, although this difference was not statistically significant. Mean change in best-corrected distance visual acuity and the proportion of eyes with corneal oedema, posterior capsule opacification or other complications were not significantly different between cohorts when adjusted for multiple comparisons. Conclusions: In this single-centre, single-surgeon retrospective electronic medical record database study using divide and conquer technique, femtosecond laser-assisted cataract surgery was associated with significantly lower cumulative dissipated energy when compared to manual phacoemulsification cataract surgery. This supports the hypothesis that femtosecond laser-assisted cataract surgery involves less mechanical trauma, which might lead to more consistent refractive and safety outcomes than manual phacoemulsification cataract surgery, though such outcomes were found to be comparable in this study.

scholarly journals Changes in Retinal Vasculature and Thickness After Femtosecond Laser-assisted Cataract Surgery and Conventional Cataract Surgery Using Optical Coherence Tomography Angiography

2022 ◽  
Author(s):  
Hong Zhang ◽  
Liangzhang Tan ◽  
Fang Tian ◽  
Xue Gong ◽  
Lu Chen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Optical Coherence Tomography Angiography ◽  
Macular Thickness ◽  
Retinal Vasculature ◽  
Optical Coherence ◽  
Age Related

Abstract Purpose To assess the changes in retinal vasculature and thickness after femtosecond laser-assisted cataract surgery (FLACS) using optical coherence tomography angiography (OCTA).Methods Fifty-six eyes of 56 patients with age-related cataract were enrolled in this study. Patients were divided into FLACS or conventional phacoemulsification surgery (CPS) due to the choice of operation. Vessel density (VD) and thickness at the macular area and optic nerve head (ONH) were checked by OCTA at baseline and at 1 day, 1 month and 3 months after cataract surgery.Results In the FLACS group: The radial peripapillary capillary (RPC) density displayed a significant reduction during the follow-up (P < 0.05), even when the retinal nerve fiber layer (RNFL) thickness was not significantly changed. There was a significant negative correlation between the changes in RPC density and femtosecond laser-assisted pre-treatment time (FLAPT) at 1 day and 1 month after cataract surgery respectively (both P < 0.05). At 3 months postoperatively, the macular thickness had a significant increase in all regions (all P < 0.05). In the CPS group, the retinal VD and thickness did not show statistically significant changes in all regions during the follow-up (all P > 0.05). However, the best corrected visual acuity (BCVA) was significantly improved in both groups postoperatively (both P < 0.001).Conclusions OCTA provided a promising analysis of retinal vascular alterations, demonstrating the reduction of RPC density and the increase of macular thickness after FLACS. However, these changes had no effect on the improvement of visual acuity after cataract surgery.

scholarly journals Visual quality after implantation of trifocal intraocular lenses in highly myopic eyes with different axial lengths

2021 ◽  
Vol 14 (3) ◽  
pp. 371-377
Author(s):  
Hui Liu ◽  
◽  
Hai-Jun Xia ◽  
Jin Zhou ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Results ◽  
Quality Parameters ◽  
Optical Quality ◽  
Intraocular Lenses ◽  
Quality Analysis ◽  
Modulation Transfer ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Near Visual Acuity

AIM: To analyze postoperative clinical results after implantation of trifocal intraocular lenses (IOLs) in highly myopic eyes with different axial lengths (ALs). METHODS: This retrospective study describes 61 eyes of 44 patients that were implanted with trifocal diffractive IOLs (AT LISA tri 839MP). Twenty-one eyes (15 patients) were included in the AL<26 mm group, 19 eyes (13 patients) in the AL≥26 mm and <28 mm group, and 21 eyes (16 patients) in the AL≥28 mm group. Postoperative outcomes, including corrected and uncorrected distance visual acuity (UDVA), intermediate and near visual acuity at 167 cd/m2 luminance, depth of focus at 85 cd/m2 luminance, and objective optical quality parameters assessed using the Optical Quality Analysis System (OQAS), were compared among the groups at 3mo. RESULTS: There were no significant differences in the mean UDVA, uncorrected intermediate visual acuity, uncorrected near visual acuity, corrected distance visual acuity, distance-corrected intermediate visual acuity, and distance-corrected near visual acuity (DCNVA) among the three groups (P>0.05). Better near and intermediate visual acuity (from -1.5 D to -3.0 D) were noted on the defocus curve of the AL<26 mm group (P<0.01 vs AL≥28 mm group). Significantly higher objective scatter index (OSI) values and lower modulation transfer function (MTF) cut-off values, Strehl ratio (SR), and OQAS values (OVs) were observed in the AL≥28 mm group (P<0.01 vs AL<26 mm group). All OQAS parameters had statistically significant correlations with DCNVA and visual acuity at the vergence of -2.5 D (P<0.05 to P<0.01). CONCLUSION: Implantation of trifocal IOLs provides good short-term visual and refractive outcomes in highly myopic eyes with different ALs. However, the near vision decreases in the extremely myopic eyes at lower luminance, which is associated with the lower objective optical quality in these eyes.

scholarly journals Femtosecond laser-assisted cataract surgery compared with phacoemulsification: the FACT non-inferiority RCT

2021 ◽  
Vol 25 (6) ◽  
pp. 1-68
Author(s):  
Alexander C Day ◽  
Jennifer M Burr ◽  
Kate Bennett ◽  
Rachael Hunter ◽  
Catey Bunce ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
The Mean

Background Cataract surgery is one of the most common operations. Femtosecond laser-assisted cataract surgery (FLACS) is a technique that automates a number of operative steps. Objectives To compare FLACS with phacoemulsification cataract surgery (PCS). Design Multicentre, outcome-masked, randomised controlled non-inferiority trial. Setting Three collaborating NHS hospitals. Participants A total of 785 patients with age-related cataract in one or both eyes were randomised between May 2015 and September 2017. Intervention FLACS (n = 392 participants) or PCS (n = 393 participants). Main outcome measures The primary outcome was uncorrected distance visual acuity in the study eye after 3 months, expressed as the logarithm of the minimum angle of resolution (logMAR): 0.00 logMAR (or 6/6 if expressed in Snellen) is normal (good visual acuity). Secondary outcomes included corrected distance visual acuity, refractive outcomes (within 0.5 dioptre and 1.0 dioptre of target), safety and patient-reported outcome measures at 3 and 12 months, and resource use. All trial follow-ups were performed by optometrists who were masked to the trial intervention. Results A total of 353 (90%) participants allocated to the FLACS arm and 317 (81%) participants allocated to the PCS arm attended follow-up at 3 months. The mean uncorrected distance visual acuity was similar in both treatment arms [0.13 logMAR, standard deviation 0.23 logMAR, for FLACS, vs. 0.14 logMAR, standard deviation 0.27 logMAR, for PCS, with a difference of –0.01 logMAR (95% confidence interval –0.05 to 0.03 logMAR; p = 0.63)]. The mean corrected distance visual acuity values were again similar in both treatment arms (–0.01 logMAR, standard deviation 0.19 logMAR FLACS vs. 0.01 logMAR, standard deviation 0.21 logMAR PCS; p = 0.34). There were two posterior capsule tears in the PCS arm. There were no significant differences between the treatment arms for any secondary outcome at 3 months. At 12 months, the mean uncorrected distance visual acuity was 0.14 logMAR (standard deviation 0.22 logMAR) for FLACS and 0.17 logMAR (standard deviation 0.25 logMAR) for PCS, with a difference between the treatment arms of –0.03 logMAR (95% confidence interval –0.06 to 0.01 logMAR; p = 0.17). The mean corrected distance visual acuity was 0.003 logMAR (standard deviation 0.18 logMAR) for FLACS and 0.03 logMAR (standard deviation 0.23 logMAR) for PCS, with a difference of –0.03 logMAR (95% confidence interval –0.06 to 0.01 logMAR; p = 0.11). There were no significant differences between the arms for any other outcomes, with the exception of the mean binocular corrected distance visual acuity with a difference of –0.02 logMAR (95% confidence interval –0.05 to 0.00 logMAR) (p = 0.036), which favoured FLACS. There were no significant differences between the arms for any health, social care or societal costs. For the economic evaluation, the mean cost difference was £167.62 per patient higher for FLACS (95% of iterations between –£14.12 and £341.67) than for PCS. The mean QALY difference (FLACS minus PCS) was 0.001 (95% of iterations between –0.011 and 0.015), which equates to an incremental cost-effectiveness ratio (cost difference divided by QALY difference) of £167,620. Limitations Although the measurement of outcomes was carried out by optometrists who were masked to the treatment arm, the participants were not masked. Conclusions The evidence suggests that FLACS is not inferior to PCS in terms of vision after 3 months’ follow-up, and there were no significant differences in patient-reported health and safety outcomes after 12 months’ follow-up. In addition, the statistically significant difference in binocular corrected distance visual acuity was not clinically significant. FLACS is not cost-effective. Future work To explore the possible differences in vision in patients without ocular co-pathology. Trial registration Current Controlled Trials ISRCTN77602616. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 6. See the NIHR Journals Library website for further project information. Moorfields Eye Charity (grant references GR000233 and GR000449 for the endothelial cell counter and femtosecond laser used).

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

2020 ◽  
pp. bjophthalmol-2019-314548
Author(s):  
Daliya Dzhaber ◽  
Osama M Mustafa ◽  
Fares Alsaleh ◽  
Yassine J Daoud
Keyword(s):  
Clinical Trial ◽  
Visual Acuity ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Controlled Clinical Trial ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Randomised Controlled Clinical Trial ◽  
Randomised Controlled

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.

A randomised controlled trial comparing femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery: 12-month results

2020 ◽  
pp. bjophthalmol-2020-316311
Author(s):  
Nick Stanojcic ◽  
Harry William Roberts ◽  
Vijay K Wagh ◽  
Ji-Peng Olivia Li ◽  
Khayam Naderi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Randomised Controlled Trial ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Controlled Trial ◽  
Corneal Thickness ◽  
Posterior Capsular Opacification ◽  
Distance Visual Acuity ◽  
Patient Reported ◽  
Randomised Controlled

AimsTo report 12-month outcomes of randomised controlled trial comparing conventional phacoemulsification surgery (CPS) with femtosecond laser-assisted cataract surgery (FLACS).MethodsThis was a single-centre, prospective single-masked randomised case-controlled trial. Four hundred patients were randomised to CPS or FLACS with the LenSx platform (Alcon Laboratories Inc.). Visual acuity, refraction, central corneal thickness, endothelial cell loss (ECL), adverse events and quality of life outcomes, using EuroQOL 5-dimensions (EQ-5D-3 L) and cataract surgery patient-reported outcome measures (PROMs) questionnaires (Cat-PROM5), were recorded.ResultsTwo hundred and thirty four patients (58.5%) attended 12-month follow-up (116 FLACS, 118 CPS). Mean LogMAR unaided distance visual acuity) (±SD) was 0.12 (0.18) with FLACS and 0.13 (0.19) with CPS (p=0.68; 95% Confidence Interval [CI]−0.06,0.04). Mean spherical equivalent (SE) refraction was −0.1±0.6 diopters (D) with FLACS and −0.2±0.6 D with CPS (p=0.44; 95% CI −0.09, 0.21). Mean corrected distance visual acuity (±SD) was −0.01 (0.1) with FLACS and 0(0.1) with CPS (p=0.45; 95% CI −0.04,0.02). Two patients per group underwent YAG laser capsulotomy for posterior capsular opacification (p=1). Mean ECL (per mm2±SD) was 301±320 with FLACS and 228±303 with CPS (p=0.07; 95% CI −7.26, 153.26). Mean Cat-PROM scores (±SD) were −5.5 (2.6) with FLACS and −5.8 (2.5) with CPS (p=0.3; 95% CI 0.31,1.01). EQ5-3DL mean index score (±SD) was 0.92 (0.13) with FLACS and 0.89 (0.14) with CPS (p=0.1; 95% CI −0.1, 0.01). Vector analysis comparing manual limbal relaxing incisions (LRIs) and intrastromal femtosecond laser-assisted astigmatic keratotomies (iFAKs) showed a greater correction index (p=0.02; 95% CI 0.06 to 0.60) and smaller difference vector (p=0.046; 95% CI −0.54, −0.01) with iFAK.ConclusionsThere were no differences in vision, refraction, adverse postoperative events or PROMs between FLACS and CPS groups at 12 months. iFAKs may provide more effective astigmatic correction compared to LRIs, 12 months postoperatively.

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