Clinical outcomes of femtosecond laser–assisted cataract surgery versus conventional phacoemulsification surgery for hard nuclear cataracts

Abstract

To compare the outcomes between femtosecond laser-assisted cataract surgery (femtosecond group) and conventional phacoemulsification cataract surgery (conventional group) in patients with hard nuclear cataract. Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China. Prospective consecutive nonrandomized comparative cohort study. According to the Emery-Little classification, cataract patients with a grade 4 or 5 hard nuclei were assigned to 1 of the 2 groups. The endothelial cell density (ECD), central corneal thickness (CCT), and uncorrected and corrected (CDVA) distance visual acuities were evaluated preoperatively and 1day, 1week, 1month, and 3months postoperatively. The study comprised 95 eyes (47 in the femtosecondgroup; 48 in the conventional group). The effective phacoemulsification time, absolute phaco time, and mean ultrasound power were lower in the femtosecond group (P<.001, P=.001, and P<.001, respectively). The ECD in the conventional group was lower and the changes in endothelial cell loss was different between the 2 groups throughout the follow-up (both P<.001). The CCT increased after surgery, and the thickness was greater in the conventional group at 1day postoperatively (P<.05); it then returned to preoperative levels 1month postoperatively in the femtosecond group and at 3months in the conventional group. The CDVA was stable by 1month postoperatively in the femtosecond group and by 3months in the conventional group. Compared with conventional phacoemulsification, femtosecond laser-assisted cataract surgery for hard nuclear cataracts conserved phacoemulsification power, provided a significant reduction in corneal endothelial damage, and led to faster visual rehabilitation.