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A comparative cohort study of visual outcomes in femtosecond laser-assisted versus phacoemulsification cataract surgery

Citation

Ewe, SYP and Abell, RG and Oakley, CL and Lim, CHL and Allen, PL and McPherson, ZE and Rao, A and Davies, PEJ 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 Statement

Copyright 2016 by the American Academy of Ophthalmology

DOI: doi:10.1016/j.ophtha.2015.09.026

Abstract

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 = 0.0003) with a greater proportion of LCS cases achieving BCVA >20/30 (LCS 89.7% vs. PCS 84.2%; P = 0.0077). However, PCS cases had more letters gained compared with LCS cases (13.5 vs. 12.5 letters; P = 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 Details

Item Type:Refereed Article
Keywords:cataract surgery, femtosecond laser, visual outcomes
Research Division:Medical and Health Sciences
Research Group:Ophthalmology and Optometry
Research Field:Ophthalmology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Surgical Methods and Procedures
Author:Allen, PL (Dr Penny Allen)
ID Code:109706
Year Published:2016
Web of Science® Times Cited:9
Deposited By:Rural Clinical School
Deposited On:2016-06-28
Last Modified:2017-10-19
Downloads:0

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