Randomized controlled bilateral comparison of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification

OBJECTIVES: To evaluate the influence of femtosecond laser-assisted cataract surgery (FLACS) on the post-operative capsular bag and visual performance using a novel aspheric hydrophobic intraocular lens (IOL).

DESIGN: Randomized controlled bilateral study.

SETTING: Department of Ophthalmology and Optometry, Kepler University Hospital, Linz, Austria.

PARTICIPANTS: Patients scheduled for bilateral cataract surgery.

INTERVENTIONS: Patients were scheduled either for conventional cataract surgery or femtolaser-assisted cataract surgery.

MAIN OUTCOME MEASURES: Anterior chamber depth, IOL tilt, IOL decentration, best-corrected distance visual acuity, uncorrected distance visual acuity.

RESULTS: In total, 100 eyes of 50 patients were included in this study. After 6 months, there was no relevant difference between the FLACS and the conventional cataract group regarding anterior chamber depth (4.56±1.68 mm and 4.60±0.26 mm; p=0.903), tilt (4.87°±2.17° and 4.37°±1.62°; p=0.124) or decentration (0.28±0.14 mm and 0.33±0.20 mm; p=0.414), respectively. The postoperative mean spherical equivalent showed a slight hyperopic shift with no relevant difference between both groups (+0.17±0.49 D and +0.19±0.50 D; p=0.996) with a target refraction of emmetropia or myopia (-2.5 D).

CONCLUSIONS: FLACS was not superior to manual cataract surgery regarding capsular bag or visual performance, and the investigated IOL was safe and stable.

TRIAL REGISTRATION NUMBER: NCT06069752.