Macular morphology assessed by optical coherence tomography image segmentation after femtosecond laser–assisted and standard cataract surgery

Abstract

To evaluate and compare thickness changes in the retinal layers in the macula with optical coherence tomography (OCT) segmentation software after femtosecond laser-assisted phacoemulsification (study group) and conventional phacoemulsification (control group). Department of Ophthalmology, Semmelweis University, Budapest, Hungary. Case-control study. Total retinal thickness of the macula was evaluated using Stratus OCT 4 to 8 weeks postoperatively. The OCT images were segmented using OCT retinal image analysis software. Regional thickness data in the central area, inner rings, and outer rings were obtained and absolute and relative thicknesses of the individual retinal layers in the 2 study groups compared. Relative thickness was calculated as the ratio of the retinal layer to the total retinal thickness. All surgeries were uneventful. Statistically significant differences were found in absolute outer nuclear layer thickness and relative outer nuclear layer thickness in the inner and outer macular rings between the 2 groups. After adjusting for effective phaco time in multivariate modeling, type of surgery showed a significantly lower relative outer nuclear layer ratio in the inner retinal ring (0.26 with 95% confidence interval [CI], 0.25-0.27 versus 0.28 with 95% CI, 0.27-0.29; P=.03) and in the outer retinal ring (0.27 with 95% CI, 0.25-0.28 versus 0.29 with 95% CI, 0.28-0.31; P=.02) in the study group. After cataract surgery, macular edema was detectable mainly in the outer nuclear layer in both groups but was significantly less using the femtosecond laser platform.