Comparative study of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in
Ellen F Wang1, Andrew Worsley1, Philip J Polkinghorne1
1Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Importance:
To compare the safety and outcomes of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification in post-vitrectomy eyes.
Background:
To compare visual outcomes and adverse outcomes of FLACS and conventional phacoemulsification in vitrectomized eyes.
Design:
Single surgeon, retrospective study set in a private clinic in Auckland, New Zealand. Patients selected in a chronological manner, without masking or randomization.
Participants:
Only patients undergoing cataract extraction following vitrectomy were included.
Methods:
The last 25 surgeries performed prior to acquisition of the femtosecond laser and the first 25 surgeries performed following acquisition of the femtosecond laser were included. Patient demographic data, preoperative and postoperative visual acuities were collected. Intraoperative and postoperative complications were compared. Follow-up ranged from 1 to 74 months.
Main Outcome Measures:
The main outcome measures are postoperative visual outcomes and intra- and postoperative complications for both groups.
Results:
Results of FLACS compared to conventional phacoemulsification are as follows: preoperative logMAR best corrected visual acuity (BCVA) (0.63 vs. 0.69), postoperative logMAR BCVA (0.17 vs. 0.19), posterior capsule complications (0% vs. 12%, P = 0.235), cystoid macular oedema (CMO) (12% vs. 20%, P = 0.705) and postoperative neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy (16% vs. 48%, P = 0.032).
Conclusions And Relevance:
FLACS demonstrates comparable visual outcomes to conventional phacoemulsification. Whilst outcomes measured were not statistically significant, except postoperative YAG capsulotomy, FLACS showed a trend towards a better intraoperative and postoperative safety profile. Femtosecond laser offers a theoretical advantage in reducing complication rates in post-vitrectomy eyes, further larger studies are needed.
