Carmen Oakley

PURPOSE: To evaluate the visual outcomes of femtosecond laser-assisted cataract surgery (LCS) compared with phacoemulsification cataract surgery (PCS) in patients undergoing toric IOL insertion.

METHODS: Patients undergoing LCS and PCS between January 2012 and July 2014 were included in the study.† The LCS group underwent femtosecond laser pretreatment for the anterior capsulotomy, lens fragmentation +/- corneal incisions. Otherwise, standard phacoemulsification surgery and foldable toric intraocular lens insertion proceeded in all cases.

RESULTS: A total of 439 eyes from 342 patients were included in the study; with 107 eyes in the PCS group and 332 in the LCS group. Baseline demographics were similar, although the LCS group had better baseline vision (37% of patients 6/9 or better compared with 26% in PCS group). Eighty three percent of the LCS eyes had postoperative BCVA of 6/9, and 93.5% had BCVA 6/12 or better compared to 60% and 78% in the PCS group respectively (p=0.002). However, there was no significant difference for change in BCVA between the groups. (Median gain in ETDRS letter 8.4 for PCS vs 9.4 for LCS) There was a difference in mean absolute error between the groups (mean -0.25D PCS vs -0.52D LCS p=0.03).

CONCLUSION: Whilst it appears that a greater percentage of patients achieve good visual outcomes with LCS, the mean improvement in vision is not different between the groups, suggesting the PCS group may have other co ñ morbidities limiting their visual potential. Overall improvement in vision is not superior for LCS compared with PCS.