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Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification: comparison of internal aberrations and visual quality

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Abstract

Purpose

To compare the internal aberrations and optical quality after femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS).

Methods

This study included patients who received FLACS or CPCS from January 2016 to July 2019. Postoperative examinations included wavefront measurements under pupil diameters of 3.0 mm and 5.0 mm, intraocular lens (IOL) decentration, visual acuity (VA), and refractive outcomes. Visual quality was measured with Strehl ratio and modulation transfer function (MTF). Subgroup analyses were conducted based on monofocal or multifocal-extended depth of focus (EDOF) IOL.

Results

The study consisted of 221 eyes (105 eyes in FLACS and 116 eyes in CPCS). With a pupil diameter of 5.0 mm, FLACS demonstrated a significantly lower root mean square of total internal aberration (P = 0.004), higher order aberrations (HOAs) (P = 0.034), tilt (P = 0.049), coma (P = 0.004), and spherical aberration (P = 0.014). IOL tilt was found to be positively correlated with total internal aberration (P < 0.001), HOAs (P < 0.001), and coma (P < 0.001). The FLACS group presented significantly smaller IOL decentration than the CPCS group (P < 0.001), but there were no significant differences in terms of VA and refractive outcomes between groups. In the multifocal-EDOF subgroup, Strehl ratio and MTF values were significantly higher in the femtosecond group with a 3.0-mm pupil.

Conclusion

FLACS induced significantly lower values of IOL tilt, decentration, and internal aberrations compared with the CPCS group with a pupil diameter of 5.0 mm, while no significant differences were found in the VA or optical quality over long-term observation.

Trial registration

This trial was registered at www.chictr.org.cn (registration number ChiCTR2000038965).

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Funding

This work was supported by the National Natural Science Foundation of China (81970779, 81600716) and Key Research and Development Project of Zhejiang Province (2020C03035).

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Authors and Affiliations

  1. Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China

    Yueyang Zhong, Yanan Zhu, Wei Wang, Kai Wang, Xin Liu & Ke Yao

Authors
  1. Yueyang Zhong
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  2. Yanan Zhu
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  3. Wei Wang
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  4. Kai Wang
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  5. Xin Liu
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  6. Ke Yao
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Contributions

Study concept and design (Yueyang Zhong and Ke Yao); data collection (Yueyang Zhong and Yanan Zhu); data analysis and interpretation (Yueyang Zhong and Wei Wang); drafting manuscript (Yueyang Zhong and Yanan Zhu); critical revision of manuscript (Yueyang Zhong, Wei Wang, and Ke Yao); securing funding (Yanan Zhu, Wei Wang, and Ke Yao); admin, technical, or material support (Kai Wang and Xin Liu); supervision (Ke Yao); final approval (Yueyang Zhong, Yanan Zhu, Wei Wang, Kai Wang, Xin Liu, and Ke Yao).

Corresponding author

Correspondence to Ke Yao.

Ethics declarations

Ethics approval

This study was conducted with the approval of the institutional review board of the Second Affiliated Hospital of School of Medicine, Zhejiang University, China, and was in adherence to the principles of the Declaration of Helsinki.

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Written informed consent was obtained from all the patients.

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The patients signed informed consent that their clinical data may be included in scientific studies.

Conflict of interest

Pro. Ke Yao is a member of the Editorial Board of the journal. We declare no competing interests.

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Zhong, Y., Zhu, Y., Wang, W. et al. Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification: comparison of internal aberrations and visual quality. Graefes Arch Clin Exp Ophthalmol 260, 901–911 (2022). https://doi.org/10.1007/s00417-021-05441-4

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