Comparison between refractive outcomes of femtosecond laser-assisted cataract surgery and standard phacoemulsification.
Cataract
FLACS
Femtosecond
Phacoemulsification
Refractive outcomes
Journal
BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802
Informations de publication
Date de publication:
02 Jan 2020
02 Jan 2020
Historique:
received:
07
01
2019
accepted:
16
12
2019
entrez:
4
1
2020
pubmed:
4
1
2020
medline:
30
5
2020
Statut:
epublish
Résumé
To compare the visual and refractive outcomes of femtosecond laser assisted cataract surgery (FLACS) using Victus platform (Technolas Bausch and Lomb (B&L), Munich, Germany) and conventional phacoemulsification cataract surgery (CPCS). A retrospective study of 100 eyes operated for cataract. FLACS was performed in 50 eyes and CPCS was done in another 50 eyes. Preoperative and 6 months postoperative visual and refractive evaluation (efficacy, safety, predictability, and surgically induced astigmatism) as well as higher-order aberrations were analyzed. Efficacy index which equals post-operative mean of uncorrected distance visual acuity (UDVA) divided by preoperative mean corrected distance visual acuity (CDVA) was calculated in both groups. Safety index equals post-operative mean of corrected distance visual acuity (CDVA) divided by preoperative mean CDVA. Logarithm of the Minimum Angle of Resolution (LogMAR), UDVA improved in both groups after surgery (p < 0.05). It was 0.23 ± 0.20 and 0.291 ± 0.311 log MAR in FLACS and CPCS groups respectively. Safety index was 1.777 in FLACS group and 1.744 in CPCS groups showing high degree of safety of both measures. Mean surgically induced astigmatism (SIA) was 0.35 ± 0.67 D and 0.901 ± 0.882 D in FLACS and CPCS groups respectively (p = 0.015). The post-operative comparison between both groups was in favor of CPCS group vs. FLACS group regarding total aberrations (0.563 ± 0.386 vs. 0.91 ± 1.20) (p = 0.03), while low order aberrations were significantly less in FLACS group vs. CPCS group (0.64 + 0.63 vs. 2.07 + 3.15) (p = 0.027). RMS high order aberration was higher in FLACS group vs. CPCS group but of no statistical significance 0.54 ± 0.96 vs. 0.328 ± 0.360 (p = 0.082). Femtosecond laser -assisted cataract surgery was a safe and precise procedure but enhanced visual outcomes only minimally when compared to conventional cataract surgery in experienced hands. Both FLACS and manual surgeries can achieve a high efficacy, predictability and safety with slight superior outcomes in FLACS. PACTR201804003256258 (date: 27 Mar 2018) Available at: https://pactr.samrc.ac.za/.
Sections du résumé
BACKGROUND
BACKGROUND
To compare the visual and refractive outcomes of femtosecond laser assisted cataract surgery (FLACS) using Victus platform (Technolas Bausch and Lomb (B&L), Munich, Germany) and conventional phacoemulsification cataract surgery (CPCS).
METHODS
METHODS
A retrospective study of 100 eyes operated for cataract. FLACS was performed in 50 eyes and CPCS was done in another 50 eyes. Preoperative and 6 months postoperative visual and refractive evaluation (efficacy, safety, predictability, and surgically induced astigmatism) as well as higher-order aberrations were analyzed. Efficacy index which equals post-operative mean of uncorrected distance visual acuity (UDVA) divided by preoperative mean corrected distance visual acuity (CDVA) was calculated in both groups. Safety index equals post-operative mean of corrected distance visual acuity (CDVA) divided by preoperative mean CDVA.
RESULTS
RESULTS
Logarithm of the Minimum Angle of Resolution (LogMAR), UDVA improved in both groups after surgery (p < 0.05). It was 0.23 ± 0.20 and 0.291 ± 0.311 log MAR in FLACS and CPCS groups respectively. Safety index was 1.777 in FLACS group and 1.744 in CPCS groups showing high degree of safety of both measures. Mean surgically induced astigmatism (SIA) was 0.35 ± 0.67 D and 0.901 ± 0.882 D in FLACS and CPCS groups respectively (p = 0.015). The post-operative comparison between both groups was in favor of CPCS group vs. FLACS group regarding total aberrations (0.563 ± 0.386 vs. 0.91 ± 1.20) (p = 0.03), while low order aberrations were significantly less in FLACS group vs. CPCS group (0.64 + 0.63 vs. 2.07 + 3.15) (p = 0.027). RMS high order aberration was higher in FLACS group vs. CPCS group but of no statistical significance 0.54 ± 0.96 vs. 0.328 ± 0.360 (p = 0.082).
CONCLUSION
CONCLUSIONS
Femtosecond laser -assisted cataract surgery was a safe and precise procedure but enhanced visual outcomes only minimally when compared to conventional cataract surgery in experienced hands. Both FLACS and manual surgeries can achieve a high efficacy, predictability and safety with slight superior outcomes in FLACS.
TRIAL REGISTRATION NUMBER
BACKGROUND
PACTR201804003256258 (date: 27 Mar 2018) Available at: https://pactr.samrc.ac.za/.
Identifiants
pubmed: 31898534
doi: 10.1186/s12886-019-1277-9
pii: 10.1186/s12886-019-1277-9
pmc: PMC6941343
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1Références
J Cataract Refract Surg. 2012 Nov;38(11):1888-94
pubmed: 22980639
Eye (Lond). 1998;12 ( Pt 6):976-82
pubmed: 10326000
Curr Opin Ophthalmol. 2018 Jan;29(1):54-60
pubmed: 28914688
J Refract Surg. 2012 Dec;28(12):859-64
pubmed: 23231736
Arch Ophthalmol. 1993 Jun;111(6):831-6
pubmed: 8512486
Am J Ophthalmol. 2015 Apr;159(4):714-9
pubmed: 25634531
J Refract Surg. 2009 Nov;25(11):975-8
pubmed: 19921764
Surv Ophthalmol. 2004 Jan-Feb;49(1):109-22
pubmed: 14711444
Ophthalmology. 2016 Jan;123(1):178-82
pubmed: 26526634
J Refract Surg. 2013 Sep;29(9):590-5
pubmed: 24016345
Am J Ophthalmol. 2015 Aug;160(2):250-255.e2
pubmed: 25982969
Am J Ophthalmol. 2016 Oct;170:83-90
pubmed: 27496784
J Refract Surg. 2015 Sep;31(9):574-8
pubmed: 26352561
J Refract Surg. 2011 Oct;27(10):711-6
pubmed: 21986002
Ophthalmology. 2014 Jan;121(1):10-16
pubmed: 24120324
J Refract Surg. 2011 Aug;27(8):564-9
pubmed: 21688765
J Refract Surg. 2017 Apr 1;33(4):218-222
pubmed: 28407160
Br J Ophthalmol. 2019 Apr 4;:null
pubmed: 30948356
J Refract Surg. 2011 Aug;27(8):558-63
pubmed: 21710951
Clin Exp Ophthalmol. 2004 Oct;32(5):529-33
pubmed: 15498067
J Cataract Refract Surg. 2016 Dec;42(12):1779-1790
pubmed: 28007110
Clin Exp Ophthalmol. 2016 Aug;44(6):472-80
pubmed: 26716428
Ophthalmology. 2016 Oct;123(10):2113-26
pubmed: 27538796