Abstract
Background: Lens surgery with multifocal IOL implantation for presbyopia correction is performed by femtosecond laser-assisted lens surgery or conventional phacoemulsification. Objective: To compare the clinical results of femtosecond laser-assisted with low-energy pulse conventional phacoemulsification lens surgery for presbyopia correction intraindividually. Methods: Charts from patients who underwent Refractive Lens Exchange (RLE) for presbyopia correction in a single center, with Femtosecond Laser-Assisted Lens Surgery (FLALS) in one eye and Conventional Phacoemulsification (CP) in the other, were retrospectively reviewed. All eyes had the same multifocal Intraocular Lens (IOL) implanted. The clinical outcomes and the results of the level of satisfaction questionnaire were compared between the two groups according to the technique employed (FLALS vs. CP) for a period of up to four years. Stability, efficacy and safety indices were also assessed. Results: This study comprised a total of 56 eyes of 28 patients randomly assigned FLALS in one eye and CP in the other. No statistically significant difference was observed between the two techniques regarding postoperative visual acuities, duration of surgical procedure, efficacy or safety indexes (p>0.05). Refraction was stable in all FLALS eyes, whereas a change occurred in 2 eyes (7.1%) operated with CP upon 6 months postoperatively, but without statistical significance (p˃0.05). Satisfaction was slightly better with FLALS but not statistically significant (p=0.134). No immediate myosis or other adverse events after the femtosecond laser were registered. Conclusion: The parameters assessed showed no significant differences between the two techniques, in spite of a difference of refraction stability upon 6 months postoperatively.
Highlights
A considerable amount of literature comparing the clinical outcomes of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification has been produced, mostly involving toric and/or monofocal Intraocular Lens (IOL) implantation
Femtosecond laser-assisted surgery was performed in 28 eyes (50%), whereas conventional phacoemulsification was performed in 28 eyes (50%)
Regarding total procedure time, we found no clinically significant difference between Femtosecond LaserAssisted Lens Surgery (FLALS) and Conventional Phacoemulsification (CP) (p>0.05) in our study, with no expended extra time, mostly due to the fact that the employed femtosecond device is portable and it was used in the operating room, with the patient positioned in the surgical bed throughout the sequential femto-phaco procedure
Summary
Femtosecond laser technology enables a higher accuracy level of centration, circularity and adjustability in capsulotomy, when compared to Conventional Phacoemulsification (CP), besides producing customised multiplanar self-sealing corneal incisions, arcuate keratotomy and lens nucleus fragmentation [4 - 6]. A considerable amount of literature comparing the clinical outcomes of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification has been produced, mostly involving toric and/or monofocal IOLs implantation. Few studies have been published comparing FLACS versus CP accompanied by multifocal IOL implantation [12]. Lens surgery with multifocal IOL implantation for presbyopia correction is performed by femtosecond laser-assisted lens surgery or conventional phacoemulsification
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