Outcomes of femtosecond laser cataract surgery in an Egyptian cohort: a comparative study

Abstract

Aim This study aimed to compare the visual outcomes and safety of femtosecond laser-assisted cataract surgery (FLACS) to conventional phacoemulsification (CP). Design This was a prospective nonrandomized interventional clinical study. Methodology Hundred eyes with nuclear cataract were divided into two groups: group A (50 eyes) underwent FLACS using the LenSx platform (Alcon Laboratories Inc., Fort Worth, Texas, USA) and group B (50 eyes) underwent CP surgery using the Centurion Vision System (Alcon Laboratories Inc., USA). Preoperative assessment included visual acuity (VA) testing, nuclear grading and specular microscopy. Ultrasound (US) total time, cumulative dissipated energy (CDE) and amount of irrigating fluid used were recorded. Postoperative assessment at 1 week, 1 month and 3 months included uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and specular microscopy. Intra- or postoperative complications were recorded. Results There was no statistically significant difference in the US total time between both groups as a whole (P=0.248) and in each subgroup (P=0.379, 0.316 and 0.681 for NC grades 1, 2 and 3, respectively). CDE was statistically lower in FLACS with NC grade 2 (P=0.005) and 3 (P=0.006), with no significant difference with NC grade 1 (P=0.521). Irrigating fluid volume was significantly lower in the CP group as a whole (P≤0.001) and in each subgroup (P=0.004, <0.001 and <0.001 for grades 1, 2 and 3 NC). There was no significant difference between both groups in % endothelial cell loss (ECL), change in CCT, UCVA and BCVA at 1 week, 1 month and 3 months. No complications were recorded, except one case of incomplete capsulotomy with FLACS. Conclusion FLACS was associated with lower CDE than CP. However, visual outcomes were similar in both techniques.