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A Comparative Cohort Study of Visual Outcomes in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery.
Ophthalmology. 2016 Jan; 123(1):178-82.O

Abstract

PURPOSE

To evaluate visual outcomes after femtosecond laser-assisted cataract surgery (LCS) with phacoemulsification cataract surgery (PCS).

DESIGN

Prospective, multicenter, comparative case series.

PARTICIPANTS

Consecutive patients undergoing femtosecond LCS or PCS with intraocular lens insertion.

METHODS

A total of 1876 eyes of 1238 patients (422 male and 772 female) who underwent cataract surgery between January 2012 and June 2014 were included in the study: 1017 eyes from center A and 859 eyes from center B. Cases underwent clinico-socioeconomic selection. Patients with absolute LCS contraindications were assigned to PCS; otherwise, all patients were offered LCS and elected on the basis of their decision to pay (the out-of-pocket cost for LCS). Demographic and postoperative data were collected to determine differences between groups.

MAIN OUTCOME MEASURES

Six-month postoperative visual and refractive outcomes. Masked subjective refractions were performed 2 to 6 months postoperatively.

RESULTS

There were 988 eyes in the LCS group and 888 eyes in the PCS group. Baseline best-corrected visual acuity (BCVA) was better in LCS compared with PCS (20/44.0 vs. 20/51.5; P < 0.0003). Preoperative surgical refractive aim differed significantly between groups (LCS -0.28 vs. PCS -0.23; P < 0.0001). More patients who received LCS had Toric lenses implanted compared with PCS (47.4% vs. 34.8%; P < 0.0001). Postoperative BCVA was better after LCS (20/24.5 vs. 20/26.4; P = 0.0003) with a greater proportion of LCS cases achieving BCVA >20/30 (LCS 89.7% vs. PCS 84.2%; P = 0.0006) and 20/40 (LCS 96.6% vs. PCS 93.9%; P = 0.0077). However, PCS cases had more letters gained compared with LCS cases (13.5 vs. 12.5 letters; P = 0.0088), reflecting baseline BCVA differences. Mean absolute error was higher in LCS compared with PCS (0.41 diopters [D] vs. 0.35 D; P < 0.0011). The percentage of eyes within 0.5 D of error from preoperative aim refraction was higher in the PCS group (LCS 72.2% vs. PCS 82.6%; P < 0.0001).

CONCLUSIONS

Femtosecond LCS did not demonstrate clinically meaningful improvements in visual outcomes over conventional PCS.

Authors+Show Affiliations

Tasmanian Eye Institute, Launceston, Tasmania, Australia.Tasmanian Eye Institute, Launceston, Tasmania, Australia.Tasmanian Eye Institute, Launceston, Tasmania, Australia.Tasmanian Eye Institute, Launceston, Tasmania, Australia.Tasmanian Eye Institute, Launceston, Tasmania, Australia.Newcastle Eye Hospital Research Foundation, Newcastle, New South Wales, Australia.Newcastle Eye Hospital Research Foundation, Newcastle, New South Wales, Australia.Newcastle Eye Hospital Research Foundation, Newcastle, New South Wales, Australia.Tasmanian Eye Institute, Launceston, Tasmania, Australia. Electronic address: eye.vote@me.com.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

26526634

Citation

Ewe, Shaun Y P., et al. "A Comparative Cohort Study of Visual Outcomes in Femtosecond Laser-Assisted Versus Phacoemulsification Cataract Surgery." Ophthalmology, vol. 123, no. 1, 2016, pp. 178-82.
Ewe SY, Abell RG, Oakley CL, et al. A Comparative Cohort Study of Visual Outcomes in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery. Ophthalmology. 2016;123(1):178-82.
Ewe, S. Y., Abell, R. G., Oakley, C. L., Lim, C. H., Allen, P. L., McPherson, Z. E., Rao, A., Davies, P. E., & Vote, B. J. (2016). A Comparative Cohort Study of Visual Outcomes in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery. Ophthalmology, 123(1), 178-82. https://doi.org/10.1016/j.ophtha.2015.09.026
Ewe SY, et al. A Comparative Cohort Study of Visual Outcomes in Femtosecond Laser-Assisted Versus Phacoemulsification Cataract Surgery. Ophthalmology. 2016;123(1):178-82. PubMed PMID: 26526634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Comparative Cohort Study of Visual Outcomes in Femtosecond Laser-Assisted versus Phacoemulsification Cataract Surgery. AU - Ewe,Shaun Y P, AU - Abell,Robin G, AU - Oakley,Carmen L, AU - Lim,Chris H L, AU - Allen,Penelope L, AU - McPherson,Zachary E, AU - Rao,Anupam, AU - Davies,Peter E J, AU - Vote,Brendan J, Y1 - 2015/10/31/ PY - 2015/05/03/received PY - 2015/09/17/revised PY - 2015/09/17/accepted PY - 2015/11/4/entrez PY - 2015/11/4/pubmed PY - 2016/4/27/medline SP - 178 EP - 82 JF - Ophthalmology JO - Ophthalmology VL - 123 IS - 1 N2 - PURPOSE: To evaluate visual outcomes after femtosecond laser-assisted cataract surgery (LCS) with phacoemulsification cataract surgery (PCS). DESIGN: Prospective, multicenter, comparative case series. PARTICIPANTS: Consecutive patients undergoing femtosecond LCS or PCS with intraocular lens insertion. METHODS: A total of 1876 eyes of 1238 patients (422 male and 772 female) who underwent cataract surgery between January 2012 and June 2014 were included in the study: 1017 eyes from center A and 859 eyes from center B. Cases underwent clinico-socioeconomic selection. Patients with absolute LCS contraindications were assigned to PCS; otherwise, all patients were offered LCS and elected on the basis of their decision to pay (the out-of-pocket cost for LCS). Demographic and postoperative data were collected to determine differences between groups. MAIN OUTCOME MEASURES: Six-month postoperative visual and refractive outcomes. Masked subjective refractions were performed 2 to 6 months postoperatively. RESULTS: There were 988 eyes in the LCS group and 888 eyes in the PCS group. Baseline best-corrected visual acuity (BCVA) was better in LCS compared with PCS (20/44.0 vs. 20/51.5; P < 0.0003). Preoperative surgical refractive aim differed significantly between groups (LCS -0.28 vs. PCS -0.23; P < 0.0001). More patients who received LCS had Toric lenses implanted compared with PCS (47.4% vs. 34.8%; P < 0.0001). Postoperative BCVA was better after LCS (20/24.5 vs. 20/26.4; P = 0.0003) with a greater proportion of LCS cases achieving BCVA >20/30 (LCS 89.7% vs. PCS 84.2%; P = 0.0006) and 20/40 (LCS 96.6% vs. PCS 93.9%; P = 0.0077). However, PCS cases had more letters gained compared with LCS cases (13.5 vs. 12.5 letters; P = 0.0088), reflecting baseline BCVA differences. Mean absolute error was higher in LCS compared with PCS (0.41 diopters [D] vs. 0.35 D; P < 0.0011). The percentage of eyes within 0.5 D of error from preoperative aim refraction was higher in the PCS group (LCS 72.2% vs. PCS 82.6%; P < 0.0001). CONCLUSIONS: Femtosecond LCS did not demonstrate clinically meaningful improvements in visual outcomes over conventional PCS. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/26526634/A_Comparative_Cohort_Study_of_Visual_Outcomes_in_Femtosecond_Laser_Assisted_versus_Phacoemulsification_Cataract_Surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(15)01095-7 DB - PRIME DP - Unbound Medicine ER -