Format

Send to

Choose Destination
Am J Ophthalmol. 2019 Oct;206:32-39. doi: 10.1016/j.ajo.2019.04.010. Epub 2019 Apr 19.

Refractive Laser-Assisted Cataract Surgery versus Conventional Manual Surgery: Comparing Efficacy and Safety in 3144 Eyes.

Author information

1
Faculty of Medicine, University of Ottawa, Ottawa, Canada.
2
Faculty of Medicine, University of Toronto, Toronto, Canada.
3
Faculty of Biology and Medical Science, University of Western Ontario, London, Ontario, Canada.
4
York Finch Eye Associates, Toronto, Ontario, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
5
Uptown Eye Specialists, Vaughan, Ontario, Canada.
6
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Uptown Eye Specialists, Vaughan, Ontario, Canada.
7
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Uptown Eye Specialists, Vaughan, Ontario, Canada. Electronic address: s.somani@utoronto.ca.

Abstract

PURPOSE:

To report on outcomes of the efficacy and safety in 1 of the largest series of eyes undergoing either conventional manual cataract surgery (MCS) or refractive femtosecond laser-assisted cataract surgery (ReLACS).

DESIGN:

Retrospective, consecutive, interventional comparative case series.

METHODS:

This study included 3144 consecutive eyes, of which 1580 were treated via MCS, and 1564 were treated via ReLACS at Uptown Surgical Centre in Vaughan, Ontario, Canada. Preoperative characteristics, best corrected visual acuity (BCVA), mean absolute spherical error (MAE), rates of intraoperative posterior capsular rupture, and postoperative complications were evaluated.

RESULTS:

Across all eyes, ReLACS was superior to MCS for reducing surgical time (MCS: 7.7 ± 0.1 min vs ReLACS: 6.8 ± 0.1 min, P < 0.001); was less commonly associated with postoperative cystoid macular edema (OR = 0.36, 95% CI: 0.14-0.91, P = 0.031) and more commonly reduced MAE (MCS: 0.60 ± 0.02 diopters (D) vs ReLACS: 0.54 ± 0.02 D, P = 0.02). There were no differences in rates of posterior capsular rupture (P = 0.918), overall postoperative complications (P = 0.088) or final BCVA (P = 0.881). When analyzing a subgroup of more difficult cases (n = 833), ReLACS was superior to MCS for: 1) being more likely to yield an improvement of more than 0.1 logarithm of the minimum angle of resolution BCVA (OR = 1.80, 95% CI: 1.15-2.74, P = 0.01); 2) reducing MAE (MCS: 0.73 ± 0.3 D vs ReLACS: 0.60 ± 0.27 D, P = 0.04); and 3) being more likely to yield an MAE within 0.5 D (OR = 1.61, 95% CI: 1.11-2.33, P = 0.012).

CONCLUSIONS:

Across all eyes, our results support that ReLACS and MCS yield similar outcomes. However, our results show trends toward a more pronounced benefit of ReLACS compared to MCS when treating more difficult eyes.

PMID:
31009596
DOI:
10.1016/j.ajo.2019.04.010

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center