Ewe, SY and Abell, RG and Oakley, CL and Lim, CH and Allen, PL and McPherson, ZE and Rao, A and Davies, PE and Vote, BJ, A comparative cohort study of visual outcomes in femtosecond laser-assisted versus phacoemulsification cataract surgery, Ophthalmology, 123, (1) pp. 178-82. ISSN 0161-6420 (2016) [Refereed Article]
Copyright 2016 by the American Academy of Ophthalmology
Purpose: To evaluate visual outcomes after femtosecond laser-assisted cataract surgery (LCS) with phacoemulsification cataract surgery (PCS).
Design: Prospective, multicenter, comparative case series.
Participants: Consecutive patients undergoing femtosecond LCS or PCS with intraocular lens insertion.
Methods: A total of 1876 eyes of 1238 patients (422 male and 772 female) who underwent cataract surgery between January 2012 and June 2014 were included in the study: 1017 eyes from center A and 859 eyes from center B. Cases underwent clinico-socioeconomic selection. Patients with absolute LCS contraindications were assigned to PCS; otherwise, all patients were offered LCS and elected on the basis of their decision to pay (the out-of-pocket cost for LCS). Demographic and postoperative data were collected to determine differences between groups.
Main Outcome Measures:Six-month postoperative visual and refractive outcomes. Masked subjective refractions were performed 2 to 6 months postoperatively.
Results: There were 988 eyes in the LCS group and 888 eyes in the PCS group. Baseline best-corrected visual acuity (BCVA) was better in LCS compared with PCS (20/44.0 vs. 20/51.5; P < 0.0003). Preoperative surgical refractive aim differed significantly between groups (LCS 0.28 vs. PCS 0.23; P < 0.0001). More patients who received LCS had Toric lenses implanted compared with PCS (47.4% vs. 34.8%; P < 0.0001). Postoperative BCVA was better after LCS (20/24.5 vs. 20/26.4; P ¼ 0.0003) with a greater proportion of LCS cases achieving BCVA >20/30 (LCS 89.7% vs. PCS 84.2%; P ¼ 0.0006) and 20/40 (LCS 96.6% vs. PCS 93.9%; P ¼ 0.0077). However, PCS cases had more letters gained compared with LCS cases (13.5 vs. 12.5 letters; P ¼ 0.0088), reflecting baseline BCVA differences. Mean absolute error was higher in LCS compared with PCS (0.41 diopters [D] vs. 0.35 D; P < 0.0011). The percentage of eyes within 0.5 D of error from preoperative aim refraction was higher in the PCS group (LCS 72.2% vs. PCS 82.6%; P < 0.0001).
Conclusions: Femtosecond LCS did not demonstrate clinically meaningful improvements in visual outcomes over conventional PCS.
|Item Type:||Refereed Article|
|Keywords:||cataract surgery, femtosecond laser, visual outcomes|
|Research Division:||Medical and Health Sciences|
|Research Group:||Ophthalmology and Optometry|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Surgical Methods and Procedures|
|Author:||Allen, PL (Dr Penny Allen)|
|Web of Science® Times Cited:||8|
|Deposited By:||Rural Clinical School|
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