Comparison Of The Efficacy And Safety Of Femtosecond Laser – Assited Cataract Surgery And Conventional Phacoemulsification In Treating Dense Nuclear Cataracts At Cao Thang Eye Hospital

To compare the efficacy and safety of femtosecond laser–assisted cataract surgery (FLACS) with conventional phacoemulsification in the treatment of hard nuclear cataracts.

Prospective comparative study conducted at a tertiary eye center between October 2025 and February 2026.

A total of 100 eyes with hard nuclear cataracts (LOCS III grades N4–N5) were included and divided into two groups: FLACS (n=50) and conventional phacoemulsification (n=50). The femtosecond laser was used for anterior capsulotomy and lens fragmentation prior to phacoemulsification. Outcome measures included cumulative dissipated energy (CDE), endothelial cell loss, postoperative visual acuity, and surgical complications. Patients were followed for 3 months postoperatively.

FLACS significantly reduced phacoemulsification energy compared with conventional phacoemulsification (mean CDE: 8.5 ± 3.2 vs 13.7 ± 4.1; p < 0.05). Endothelial cell loss was lower in the FLACS group (7.5%) than in the phaco group (13.4%).Postoperative visual outcomes were favorable in both groups, with faster early visual recovery in the FLACS group.. At 1 week, 92% of eyes achieved BCVA ≥0.5, increasing to 98% at 1 month. At 3 months, 60% of eyes achieved BCVA ≥0.7. The overall complication rate was low, with corneal edema in 8% of cases and posterior capsule rupture in 1%.

FLACS is a safe and effective technique for managing hard nuclear cataracts. Compared with conventional phacoemulsification, FLACS reduces ultrasound energy and endothelial cell loss and facilitates faster early visual recovery while providing comparable final visual outcomes.