Refractive Outcomes After Femtosecond Laser–Assisted Cataract Surgery Versus Conventional Cataract Surgery: Initial Resident Experience
To compare intraocular lens position and refractive outcomes of femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification cataract surgery performed by ophthalmology residents.
This retrospective series included 46 eyes of 23 patients who underwent FLACS in one eye and conventional cataract surgery in the other eye, both performed by ophthalmology residents using the same intraocular lens (IOL). Exclusion criteria included previous ocular surgery and intraoperative or postoperative complications. Postoperatively, intraocular lens position as measured from the anterior corneal surface to the anterior IOL plane was estimated using anterior segment OCT. The mean absolute refractive error (MAE; mean of absolute difference between predicted and actual postoperative spherical equivalent refraction) and the proportion in each group falling within 0.5 diopters of the intended correction were also analyzed.
At least 4 weeks postoperatively, MAE in eyes undergoing FLACS and conventional phacoemulsification cataract surgery were 0.58±0.54 diopters and 0.43±0.43 diopters, respectively (P=0.24, paired t-test). 65% of FLACS procedures were within 0.5 diopters of intended spherical equivalent refraction compared to 70% of conventional cataract surgery (P =0.75, chi-squared test). In six patients who underwent OCT analysis, intraocular lens position was 4.64±0.17 mm in the FLACS eyes and 4.69±0.22 mm in the fellow conventional surgery eyes (P =0.33 for t-test, P=0.28 for F-test of variance).
These early data show that resident ophthalmologists are able to achieve predictable intraocular lens position and deliver similar refractive results when performing FLACS versus conventional phacoemulsification cataract surgery, even during the initial surgical learning curve. Further analysis of intraocular lens position and its relationship with refractive outcome will help evaluate the role of FLACS in the residency education experience.