Results of femtosecond laser-assisted cataract surgery (FLACS) with aspheric intraocular lens (IOL) for low, moderate and high astigmatism

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS) I

Session Date/Time: Sunday 08/10/2017 | 08:00-10:00

Paper Time: 08:42

Venue: Room 3.6

First Author: : S.Ti SINGAPORE

Co Author(s): :    Y. Yang   S. Chee                 

Abstract Details

Purpose:

To report postoperative visual outcomes and astigmatic changes by vector analysis following femtosecond laser-assisted cataract surgery (FLACS) with aspheric toric IOL.

Setting:

Singapore National Eye Centre

Methods:

Consecutive cases of FLACs and aspheric toric IOL (SN6AT3-T9, Alcon), refractive target ±0.5D, were included. Victus™ laser system was used for capsulotomy and fragmentation, with manual clear cornea incisions ≤2.2mm. Axes were marked manually, toric IOL placement assisted by degree gauge intraoperatively. Outcome measures: unaided visual acuity (UVA) at 6 weeks, mean absolute error (MAE), astigmatic changes (Alpins vector method, iASSORT software) based on target induced astigmatism(TIA), surgically induced astigmatism (SIA) and difference vector (DV) in 3 preoperative cylinder groups (1<1.0D; 2: 1.0-1.5D and 3: >1.5D). Visual results were benchmarked against retrospective cohort of non-FLACS cases by the same surgeons.

Results:

Study included 63 eyes (median 70 years). Biometry calculations used Zeiss IOLMaster® 500, Barrett toric calculator. Mean follow-up=45 days. Postoperative refractive cylinder was reduced by 65% (49, 61, 73% in groups 1,2 and 3 respectively, n=21 each). Mean residual refractive cylinder=0.47 ± 0.37 D. MAE=0.27±0.19 D. UVA 20/20 was achieved in 38.7%, statistically higher than manual phaco patients (17.9%, p=0.015, n=56). At 6 weeks postop, magnitude SIA =1.36 at 96°; TIA=1.23 at 90°; mean DV=0.50 at 72°. Mean correction index was 1.11, mean index of success was 0.45 (0.61, 0.47 and 0.30 in groups 1,2 and 3 respectively).

Conclusions:

FLACS for astigmatism correction provided effective unaided visual outcomes over a short term follow-up and appeared to provide higher % UVA 20/20 than non-FLACS. The overall index of success was 0.45, with better outcomes achieved in the higher astigmatism categories.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company, receives consulting fees, retainer, or contract payments from a competing company