ESCRS - PO0386 - Visual And Refractive Outcomes In Low Energy Flacs Versus Conventional Phacoemulsification Cataract Surgery: Findings From A Randomised, Controlled Clinical Trial

Visual And Refractive Outcomes In Low Energy Flacs Versus Conventional Phacoemulsification Cataract Surgery: Findings From A Randomised, Controlled Clinical Trial

Published 2023 - 41st Congress of the ESCRS

Reference: PO0386 | DOI: 10.82333/06mb-9b40

Authors: Bojan Pajic* 1 , Zeljka Cvejic 2 , Brigitte Pajic-Eggspuehler 3

1Ophthalmology,Eye Clinic ORASIS,Reinach,Switzerland;Ophthalmology,Swiss Eye Research Foundation,Reinach,Switzerland, 2Department of Physics,Faculty of Science, University of Novi Sad,Novi Sad,Serbia, 3Ophthalmology,Eye Clinic ORASIS,Reinach,Switzerland

To compare visual and refractive outcomes in low energy FLACS versus conventional phacoemulsification cataract surgery.

This a secondary analysis in a prospective randomized operative-interventional case–control study performed at the Swiss Eye Research Foundation, Eye Clinic ORASIS, Reinach, Switzerland

130 patients with age related cataract were randomized to receive either low energy FLACS with the FEMTO LDV Z8 (Ziemer Ophthalmic Systems AG) or conventional cataract surgery. 59 patients in FLACS group and 64 in conventional group (those who attended all follow-up visits) were included in the analysis. Preoperative and 1 day, 12 days, 4, 8 and 12 weeks postoperative visual and refractive outcomes, such as percentage of the eyes achieving CDVA of 20/20 or better, MRSE, Manifest Sphere, Manifest Cylinder, SEQ accuracy were analysed and compared between the two groups. Unpaired T-test assuming normal distribution was applied in this study.

There was no statistically significant difference in patients` age (p=0.25) and preoperative BCVA (p = 0.49) in the two groups. At day 1 after the surgery the mean CDVA in the FLACS group was 0.70 ± 0.30 decimal compared to 0.61 ± 0.29 in conventional (p = 0.08). On the first postoperative day, 35.6% of patients in the FLACS group achieved CDVA 20/20 or better, compared to 20.3% in the conventional group, 55.9% and 37.5% achieved CDVA of 20/25. The postoperative MRSE between the 2 groups was statistically significantly different at 4 and 12 weeks (p = 0.02 and p = 0.04). No difference in SEQ accuracy was established between the two groups, the FLACS group showed better refractive stability compared to the conventional group.

Better 1 day CVDA in low energy FLACS group indicates faster visual recovery compared to conventional surgery. This effect could be attributed to generally known decreased intra-operative manipulation and better preservation of corneal endothelial cells with FLACS coupled with negligible collateral damage and inflammation characteristic to the low energy FLACS. The low energy FLACS showed better postoperative MRSE at 4 and 12 weeks, as well as better postoperative refractive stability compared to conventional surgery. Laser capsulotomy provides the necessary conditions for refractive stability and effective lens position due to its precision, circularity and stable shape.