Comparative study of FLACS vs conventional phacoemulsification for complex cataracts in vitrectomized eyes. Issue 12 (December 2022)

• Record Type: Journal Article
• Authors: Cai, Lei; Ma, Dongmei; Xu, Xujiong; Han, Xiaoyan; Qiu, Xiaodi; Lu, Yi; Yang, Jin
• Is Part Of: Journal of cataract and refractive surgery. Volume 48:Issue 12(2022)
• Page Start: 1381
• Page End: 1387
• Publication Date: 2022-12
• Subjects: 617.7
• DOI: 10.1097/j.jcrs.0000000000000998
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : On comparing the outcomes and complications of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification, FLACS improves the surgical safety and provides quicker rehabilitation in vitrectomized eyes with hard cataracts. Abstract : Purpose: To compare the visual outcomes and complications of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification (CPS) in patients with prior pars plana vitrectomy (PPV). Setting: Department of Ophthalmology, Eye and Ears, Nose, and Throat Hospital of Fudan University, Shanghai, China. Design: Prospective randomized controlled cohort study. Method: According to the Lens Opacity Classification System III, cataract patients with nucleus grade 3 to 6 after prior PPV were randomized to 2 groups (FLACS or CPS). Endothelial cell density (ECD), central corneal thickness (CCT), and corrected distance visual acuity (CDVA) were evaluated preoperatively and at 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. Intraoperative parameters and intraoperative and postoperative complications were recorded. Results: 86 eyes (45 and 41 in the FLACS and CPS groups, respectively) were included and analyzed, among which 43 had hard nuclei (grade 5 or 6). Cumulative dissipated energy was lower and ultrasound time was shorter among FLACS patients with hard nuclei ( P < .001). CDVA was similar in both groups at the final visit ( P > .05). ECD decreased in both groups but was lower among CPS patients with hard nuclei throughout the follow-up period ( P < .05). CCT had returned to preoperative levels at the final visit in both groups; however, eyes with hard cataract in the FLACS group recovered sooner. No serious complications occurred in either group. Conclusions: FLACS is beneficial in improving surgical safety and providing quicker visual rehabilitation in vitrectomized eyes with hard nuclear cataracts.