Clinical Ophthalmology (Dec 2021)
A One Year Longitudinal Comparative Analysis of Visual Outcomes Between Femtosecond Laser-Assisted Cataract Surgery and Standard Phacoemulsification Cataract Surgery
Abstract
Majid Moshirfar,1– 3 Austin J Waite,4 James H Ellis,5 Rachel Huynh,5 John Placide,6 Matthew R Barke,6 Shannon E McCabe,1,7 Yasmyne C Ronquillo,1 Phillip C Hoopes Jr,1 Michael J Bradley,1 Phillip C Hoopes1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 3Utah Lions Eye Bank, Murray, UT, USA; 4A.T. Still University College of Osteopathic Medicine in Arizona, Mesa, AZ, USA; 5University of Utah School of Medicine, Salt Lake City, UT, USA; 6McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA; 7Mission Hills Eye Center, Pleasant Hill, CA, USACorrespondence: Majid MoshirfarHoopes Vision Research Center, 11820 S. State Street Suite #200, Draper, UT, 84020, USATel +1 801-568-0200Fax +1 801-563-0200Email [email protected]: To assess visual outcomes over time of femtosecond laser-assisted cataract surgery compared to standard phacoemulsification cataract surgery.Design: A retrospective, single-center comparative study.Methods: Patient data including demographics, ocular biometry, pre- and postoperative visual acuity, postoperative complications, primary (uncorrected distance visual acuity over time) and secondary visual outcomes (uncorrected near visual acuity, best distance visual acuity, patient complaints, satisfaction, and postoperative surgery) were gathered and statistically analyzed. Demographic differences between patients receiving femtosecond-laser assisted cataract surgery (FLACS) versus standard phacoemulsification cataract surgery (PCS) were corrected for outcome comparison. Safety, efficacy, predictability, and stability were analyzed for each procedure and compared.Results: A total of 155 eyes in PCS and 143 eyes in FLACS were analyzed at 1 week, 3 months, and 1 year using odds ratio. The odds ratio of being 20/20 or better and 20/40 or better at the specified time periods were similar and statistically insignificant at all time periods analyzed except 20/20 or better for uncorrected distance visual acuity (UDVA) at 1 year (p=0.0001) and uncorrected near visual acuity (UNVA) at 1 week (p=0.02). In both cases, the odds of being 20/20 or better favored FLACS. Mean UDVA, UNVA, and best distance visual acuity (BDVA) were all similar and statistically insignificant between the two groups. Postoperative patient complaints, safety, efficacy, predictability, and stability between the two groups showed no statistical significance.Conclusion: Despite the odds ratio of being 20/20 or better favoring FLACS for UDVA at 1 year and UNVA at 1 week, the mean logMAR UDVA, BDVA, and UNVA were similar and statistically insignificant between the FLACS and PCS groups at 1 week, 3 months, and 1 year. Differences in visual acuity were likely due to differences other than surgical approaches. While both FLACS and PCS are appropriate approaches to cataract surgery, one does not appear to be superior when assessing longitudinal markers for visual acuity, safety, efficacy, predictability and stability.Keywords: cataract surgery, cataracts, femtosecond-laser assisted cataract surgery, phacoemulsification cataract surgery, uncorrected distance visual acuity, best distance visual acuity, uncorrected near visual acuity
