COMPARISON OF SURGERY INDUCED REFRACTIVE CHANGES AFTER FEMTOSECOND LASER-ASSISTED CATARACT SURGERY IN PATIENTS WITH DIABETES MELLITUS TYPE 2.

Published 2022 - 26th ESCRS Winter Meeting

Reference: P017 | Type: Abstracts | DOI: 10.82333/mggs-7146

Authors: Celeste Briceno-Lopez* ¹ , Neus Burguera-Giménez ¹ , Mª Carmen García-Domene ² , Mª Amparo Díez-Ajenjo ² , Mª José Luque ² , Cristina Peris-Martínez ³

¹Cornea and Anterior Segment Unit,FISABIO Ophthalmological Medical Centre,Valencia,Spain;Department of Optics and Vision Sciences,University of Valencia,Burjassot, Valencia,Spain, ²Department of Optics and Vision Sciences,University of Valencia,Burjassot, Valencia,Spain;Cornea and Anterior Segment Unit,FISABIO Ophthalmological Medical Centre,Valencia,Spain, ³Cornea and Anterior Segment Unit,FISABIO Ophthalmological Medical Centre,Valencia,Spain;Department of Ophthalmology and Ocular Surgery,Faculty of Medicine, University of Valencia,Valencia,Spain

Purpose

To assess refractive outcomes in type II diabetes mellitus adult population after femtosecond laser-assisted cataract surgery (FLACS).

Setting

Cátedra Alcon-FISABIO-UVEG

Methods

This prospective comparative study was developed with patients from FISABIO Ophthalmology Medical Centre (FOM). Each patient went through an exhaustive ophthalmologic and optometric evaluation. The sample comprised 236 subjects with senile cataracts, with LOCSIII grades from N2 to N4. The control group comprised 159 eyes, and the experimental group with type II diabetes mellitus (DM) had 77 eyes. Patients with dense cataracts (>N4) and previous corneal surgical procedures as well as any other corneal pathological condition that could compromise corneal integrity were excluded from the study. Horizontal and vertical corneal astigmatism (K_H,K_V) were determined using the Topcon KR-8100P autokeratorefractometer (Topcon, Tokyo, Japan). Subjective refraction, in vectorial components (M, J₀, J₄₅) and best corrected visual acuity (BCVA) were also measured. This study included eyes of patients scheduled to have FLACS using 60kHz IntraLase® (IntraLase, IntraLase Corp.). The medical and optometric revisions, were performed before, 24 hours and 3 months after surgery.

Results

The variables compared in the analysis were, age, endothelial cell density, vertical and horizontal keratometric power, axis of corneal meridians, vector components of subjective refraction and BCVA before and after FLACS. The Kolmogorov-Smirnov normality test revealed that all the variables followed a non-parametric distribution (p<0,05). U Mann-Whitney’s test for independent samples revealed significant differences in the horizontal corneal axis and BCVA between both groups before the FLACS (z= -2,485, p=0,013 and z= -3,653, p=0,000; respectively). Additionally, the mean value of K_H measured for both samples showed lower values for the control group in each stage of the study. However, these differences were only significant in the K_H measured 24 hours after the surgery (z= -2,083; U= 5131,5; p=0,037) between both groups.

Conclusion

Femtosecond laser-assisted surgery has showed comparable results, repeatability, and reproducibility to manual incision phacoemulsification. The control of certain parameters such as the position, width, length, and architecture of the incision turns FLACS is a reliable tool to predict surgically induced refractive errors, changes in refraction and biomechanical corneal parameters. Horizontal keratometric radii are different (p=0,037) when both groups are compared after FLACS. K_H changed for the experimental group as seen on the 24 hours follow-up, although these changes are not clinically relevant due to the slight increase on the power of the corneal astigmatism. The initial K_Hwas steeper, and the axis of the astigmatism changed in counterclockwise direction on the diabetic group. Finally, the pachymetric outcomes, refraction and BCVA of diabetic and healthy patients are similar after FLACS.