Purpose: To determine whether postoperative ocular inflammation is less after femtosecond laser–assisted cataract surgery than after conventional phacoemulsification (manual) cataract surgery.

Setting: Private clinic, Launceston, Tasmania, Australia.

Design: Prospective consecutive investigator-masked nonrandomized parallel cohort study.

Methods: Consecutive cataract patients who had femtosecond laser–assisted cataract surgery or manual cataract surgery by the same surgeon at a single center were assessed. The primary endpoint was postoperative aqueous flare measured by laser flare photometry at 1 day and 4 weeks. Secondary endpoints included retinal thickness measured by optical coherence tomography and slitlamp examination findings at 4 weeks.

Results: The per-protocol population comprised 176 patients (100 in laser group; 76 in manual group). Postoperative aqueous flare was significantly greater in the manual cataract surgery group at 1 day (P=.0089) and at 4 weeks (P=.003). There was a significant correlation between effective phacoemulsification time and 1-day postoperative aqueous flare (r = 0.35, P<.0001). The increase in outer zone thickness measured by optical coherence tomography was less in the laser group (P=.007).

Conclusion: Anterior segment inflammation was less after femtosecond laser–assisted cataract surgery than after manual cataract surgery, and this appeared to be due to a reduction in phacoemulsification energy.