Femtosecond laser-assisted cataract surgery may provide more stable refraction at 6 months

Issue: October 10, 2015

Femtosecond laser-assisted cataract surgery with IOL implantation may induce a lower variability of anterior chamber depth over time with more stable postoperative refraction compared with conventional cataract surgery, according to a study.

Perspective from Steven B. Siepser, MD, FACS

The prospective study evaluated 40 eyes that underwent femtosecond laser-assisted cataract surgery and 40 eyes that underwent manual cataract surgery to compare IOL axial movements over a 6-month follow-up.

All patients in both groups achieved corrected distance visual acuity of 20/40 or better. There were no significant differences in median absolute error between the two groups.

At week 1, there was a slightly more myopic spherical equivalent refraction in the femtosecond laser group vs. the manual group, but at months 1 and 6, the mean spherical equivalent showed a hyperopic shift of 0.17 ± 0.23 D in the femtosecond laser group and a myopic shift of –0.23 ± 0.10 D in the manual group (P < .001).

The overall anterior chamber depth change was higher in the manual group at –0.06 ± 0.03 mm vs. 0.03 ± 0.02 mm in the femtosecond laser group (P < .001).

At 6 months, the deviation of obtained capsulotomy/capsulorrhexis area compared with the expected intended area was 1.6 ± 0.7 mm² in the femtosecond laser group and 3.4 ± 1.3 mm² in the manual group (P < .001).

At all time points, the distance between pupil centroid and IOL centroid was significantly lower in the femtosecond laser group vs. the manual group (P < .001). – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

Perspective

Steven B. Siepser, MD, FACS

This beautifully executed, controlled and exacting study clearly demonstrates one thing to a senior ophthalmologist: We have come a very, very long way in the last 4 decades. To put this in perspective, 40 years ago cataract surgery was the end of life as most patients knew it, and the advent of IOL implants and advances accompanying that technology brought ophthalmology into the modern era. It is truly fascinating that we can actually measure these small differences, but this proves that as we refine technologies, differences become smaller, and the advantages, although less impressive, are significant. This is just another fine study that pushes us on to the next frontier. Femtosecond laser-assisted cataract surgery is here to stay and is truly an incremental wonder.

Steven B. Siepser, MD, FACS

OSN Cataract Surgery Board Member

Disclosures: Siepser reports no relevant financial disclosures.

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Sources/Disclosures

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Source:

Toto L, et al. J Refract Surg. 2015;doi:10.3928/1081597X-20150727-02.