"Evaluation Of Preoperative Predominance Parameters For Indications For Femtosecond Laser-Assisted Cataract Surgery"

This retrospective study aims to analyze the most crucial and widely mentioned preoperative ophthalmologic variables in the literature, which could play a key role as indications for Femtosecond Laser-Assisted Cataract Surgery (FLACS) in a patient cohort who received FLACS.

All surgical procedures were performed at the University Eye Clinic in Bochum, Germany.

This study examined 309 eyes and analyzed the individual risk factors that present challenges in performing cataract surgery. The data analysis showed the following outcomes: high hyperopia axial length in 21 eyes, damaged suspensory apparatus in 38 eyes, pseudoexfoliation syndrome in 13 eyes, high myopia in 42 eyes, astigmatism (up to -0.75 D) in 168 eyes, shallow anterior chamber (ACD < 2.8 mm) in 59 eyes, low endothelial cell count (< 2000 cells/mm²) in 90 eyes with an average of 1664.14 cells/mm², and hard lens (> LOCS IV) in 50 eyes.

The mean age of patients was 73.14 ± 8.06 years (range 46-93 years), with 162 right eyes (OD) and 147 left eyes (OS). Preoperatively, the uncorrected visual acuity (UDVA) was 0.23 ± 0.164 (range 0.02 to 0.63), 0.756 LogMAR; the best-corrected visual acuity (BCVA) was 0.47 ± 0.163 (range 0.029 to 0.80), 0.37 LogMAR; and the manifest subjective spherical equivalent (MSE) was -0.18 ± 2.1 D (range -12.75 to +5.88 D). The predominant variables in descending order were astigmatism, low endothelial cell count, shallow anterior chamber, hard lens, high myopia, and damaged suspensory apparatus. Other notable variables included pseudoexfoliation syndrome and high hyperopia axial length.

Astigmatism had the lion's share in the outcomes of the evaluation of preoperative individual variables for FLACS indication, followed by low endothelial cell count, shallow anterior chamber, hard lens, and refractive errors such as high myopia. These results indicate that special attention should be given to these preoperative variables when planning cataract surgery and could be a future indication for FLACS, particularly in planning astigmatism correction via arcuate incision and protection of endothelial cells.