Refractive and visual outcomes of femtosecond laser-assisted cataract surgery

Abstract

Objective: To compare refractive and visual acuity outcomes of femtosecond laser-assisted cataract surgery (FLACS) to manual surgery. Participants: Consecutive series of patients in a private ophthalmic practice in Sydney, with 337 eyes undergoing FLACS on the LenSx platform and 230 eyes manual cataract surgery. Main Outcome Measures: Astigmatism, surgically-induced corneal astigmatism, achievement of target refraction and corrected and uncorrected distance visual acuity (UDVA). Results: The FLACS group had statistically less mean residual post-operative astigmatism by 0.18D (p<0.001) than the manual group. The femtosecond laser produced equivalent mean magnitude and variability of surgically-induced corneal astigmatism compared to manual cataract surgery. Both surgical methods had equivalent achievement of target spherical equivalent (69% within 0.5 D of target refraction, p=0.911). In eyes with good visual potential and an emmetropic target, post-operative UDVA was statistically better in the femtosecond group with an average improvement of 2.4 logMAR letters (p=0.020). Conclusions: Femtosecond cataract surgery produced less residual post-operative refractive astigmatism and better unaided distance visual acuity compared to manual cataract surgery. However there was no improvement in the achievement of target post-operative refraction.