In a recent study, Nithianandan and colleagues chose to examine one of the largest series of eyes undergoing either conventional manual cataract surgery or refractive femtosecond laser-assisted cataract surgery. They evaluated 3144 eyes (1580 manual cataract surgery, 1564 femtosecond cataract surgery) on best corrected visual acuity (BCVA), mean absolute spherical error (MAE), rates of intraoperative posterior capsular rupture (PCR), and rates of postoperative complications.
In all eyes, laser-assisted cataract surgery was associated with reduced surgical time and less risk of postoperative cystoid macular edema than manual cataract surgery. Laser-assisted cataract surgery was also associated with reduced MAE. There was no difference in rates of PCR, overall postoperative complications, or the final BCVA.
The researchers also analyzed a subgroup of more difficult cases (833 eyes). In these instances, laser-assisted cataract surgery was more likely to yield an improvement of more than 0.1 LogMAR BCVA, reduce MAE, and yield a MAE within 0.5 D.
“Across all eyes, our results support that ReLACS and MCS yield similar outcomes,” write the authors. “However, our results show trends for a more pronounced benefit of ReLACS compared to MCS when treating more difficult eyes.”
Full findings are published in the American Journal of Ophthalmology.