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Manual versus bladeless femtosecond laser-assisted small incision cataract surgery: comparison of refractive outcomes

Poster Details

First Author: A.Kanellopoulos GREECE

Co Author(s):    G. Asimellis                    

Abstract Details


Comparative evaluation of refractive outcomes of manual small-incision versus femtosecond-laser assisted clear-cornea cataract surgery.

Setting: Clinical and Research Eye Institute


We evaluated 133 consecutive eyes subjected to cataract surgery. Two groups were formed: group-A manual (n=66); group-B femtosecond-laser assisted (n=67), in which the LenSx (Alcon Surgical, Ft. Worth, TX) laser was employed. All cases were evaluated for refraction, visual acuity, keratometry, tomography, pachymetry, endothelial cell counts, intraocular pressure, and type of spherical or toric IOL implanted. The groups were matched for age, gender, pre-operative vision metrics, and cataract severity. Follow-up time was up to 1 year. Toric IOL subgroups were also compared.


In group-A post-operative UDVA was 20/20 or better in 61.5% of the eyes and 20/25 in 78.5%. The femtosecond group-B had improved outcomes (p=0.075 and p=0.042): post-operative UDVA was 20/20 in 62.7% of the eyes and 20/25 in 85.1%. Linear regression scatterplots of achieved versus attempted spherical equivalent had excellent regression coefficients (a=1.01 group-A, 0.97 group-B). There were 67.7% cases in group-A and 67.2% in group-B (p=0.873) within ±0.50D of refractive equivalent. Slight trend of under-correction was noted in group-A. Average residual manifest cylinder in the toric subgroup-A was -0.50D (95% Limit-of-Agreement, LoA=-0.78D), and in toric subgroup-B -0.45D (95% LoA=-0.45D).


Refractive outcomes in terms of visual acuity, residual refractive error, as well as total phacoemulsification energy appear to favor the femtosecond laser-assisted group-A, suggesting clinical benefit in utilizing this technology in routine small-incision cataract surgery.

Financial Disclosure:

One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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