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Comparing the relative contribution of astigmatism correction and IOL power calculation predictability to refractive outcome after femtosecond laser-assisted cataract surgery (FLACS) vs traditional phacoemulsification

Poster Details

First Author: J.Bierly USA

Co Author(s):    L. Hong   C. Gao                 

Abstract Details


To compare patients who underwent FLACS to those patients who underwent traditional cataract surgery, and examine the relative contribution of astigmatism correction and IOL power calculation predictability to the final refractive outcome.


Southeast Eye Specialists, Chattanooga TN


In this retrospective study, 37 eyes from 28 patients underwent FLACS (laser group; Alcon LenSx femto-second laser), and 58 eyes from 36 patients underwent traditional cataract surgery with phacoemulsification (traditional group). Biometry was done with non-contact optical low coherence reflectometry (Lenstar LS900, Haag-Streit AG) pre and post-operatively. The final refractive outcome was analyzed using the mean refractive error (ME; difference between targeted and achieved postoperative spherical equivalent refraction), and nonparametric statistical analysis was performed to compare individual factors between the two groups


There was a significant improvement in visual acuity (P=0.029; Wilcox Rank Sum test), as well as less subjective astigmatism after surgery (P=0.027) in the laser group (0.44D) compared to traditional group (0.65D). However there was minimal change in objective astigmatism measured pre and post-operatively with biometry in both laser (0.08D±0.40) and traditional (0.06D±0.29) groups 6 weeks after surgery. There was no difference in outcome of the ME between the FLACS group (0.024D±0.296) and the traditional group (0.071D±0.347)


FLACS resulted in a significantly better visual outcome when compared to traditional surgery. This difference could be due to better astigmatism correction or more predictable IOL calculations due to the features and precision of the femtosecond laser. Since there was no significant difference between the ME for each group, improved visual outcomes can be attributed to less subjective refractive astigmatism. This improvement occurred in absence of any significant changes to objective astigmatism measurements as measured by optical biometry.

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