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A randomised controlled trial comparing femtosecond laser–assisted cataract surgery vs conventional phacoemulsification surgery: 12 month results

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First Author: N.Stanojcic UK

Co Author(s):    H. Roberts   V. Wagh   O. Li   K. Naderi   D. O'Brart        

Abstract Details

Purpose:

To report 12-month outcomes of randomized controlled trial comparing conventional phacoemulsification surgery (CPS) with femtosecond laser–assisted cataract surgery (FLACS).

Setting:

St. Thomas’ Hospital, London, UK.

Methods:

Four hundred patients were randomized to CPS or FLACS with the LenSx platform (Alcon Laboratories, Inc.). Visual acuity, refraction, central corneal thickness (CCT), endothelial cell loss (ECL), adverse events and quality of life outcomes, using EuroQOL 5-dimensions (EQ-5D-3L) and cataract surgery patient-reported outcome measures (PROMS) questionnaires (Cat-PROM5), were recorded. Patients with corneal astigmatism of 0.9D or more underwent limbal relaxing incisions (LRIs) in the CPS group and intra-stromal femtosecond laser-assisted arcuate keratotomies (iFAKs) at the time of cataract surgery.

Results:

234 patients(58.5%) attended follow-up(116 FLACS, 118 CPS). Mean LogMAR UDVA(+/-SD) was 0.12(0.18) with FLACS and 0.13(0.19) with CPS(P=0.68;95%CI-0.06,0.04). Mean spherical equivalent (SE) refraction was -0.1+/-0.6 diopters with FLACS and -0.2+/-0.6D with CPS(P=0.44;95%CI-0.09,0.21). Mean CDVA(+/-SD) was -0.01(0.1) with FLACS and 0(0.1) with CPS(P=0.45;95%CI-0.04,0.02). Two patients per group underwent YAG laser capsulotomy for posterior capsular opacification (P=1). Mean ECL(per mm2+/-SD) was 301+/-320 with FLACS and 228+/-303 with CPS (P=0.07; 95%CI -7.26,153.26). Mean CatPROM scores(+/-SD) were -5.5(2.6) with FLACS and -5.8(2.5) with CPS(P=0.3;95%CI-0.31,1.01).EQ5-3DL mean index score(+/-SD) was 0.92(0.13) with FLACS and 0.89(0.14) with CPS (P=0.1;CI-0.1,0.01).Vector analysis showed a greater Correction Index(P=0.02;95%CI0.06,0.60) and smaller Difference Vector(P=0.046;95%CI-0.54,-0.01)with iFAK than LRIs.

Conclusions:

There were no differences in vision, refraction, adverse postoperative events or PROMS between FLACS and CPS groups at 12 months. iFAKs may provide more effective astigmatic correction compared to LRIs, 12 months post-operatively.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented