Purpose: To compare the visual outcomes and complications of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification (CPS) in patients with prior pars plana vitrectomy (PPV).
Setting: Department of Ophthalmology, Eye and Ears, Nose, and Throat Hospital of Fudan University, Shanghai, China.
Design: Prospective randomized controlled cohort study.
Method: According to the Lens Opacity Classification System III, cataract patients with nucleus grade 3 to 6 after prior PPV were randomized to 2 groups (FLACS or CPS). Endothelial cell density (ECD), central corneal thickness (CCT), and corrected distance visual acuity (CDVA) were evaluated preoperatively and at 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. Intraoperative parameters and intraoperative and postoperative complications were recorded.
Results: 86 eyes (45 and 41 in the FLACS and CPS groups, respectively) were included and analyzed, among which 43 had hard nuclei (grade 5 or 6). Cumulative dissipated energy was lower and ultrasound time was shorter among FLACS patients with hard nuclei ( P < .001). CDVA was similar in both groups at the final visit ( P > .05). ECD decreased in both groups but was lower among CPS patients with hard nuclei throughout the follow-up period ( P < .05). CCT had returned to preoperative levels at the final visit in both groups; however, eyes with hard cataract in the FLACS group recovered sooner. No serious complications occurred in either group.
Conclusions: FLACS is beneficial in improving surgical safety and providing quicker visual rehabilitation in vitrectomized eyes with hard nuclear cataracts.
Copyright © 2022 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.