Comparison of functional outcomes between femtosecond laser-assisted cataract surgery and phacoemulsification in post-radial keratotomy cataract.

PURPOSE: To compare the functional outcomes between femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification in post-radial keratotomy (RK) cataract.

SETTING

Postgraduate teaching institute in a corporate setting, based in Northern India.

DESIGN

Retrospective comparative observational study.

METHODS

The study included 70 post-RK eyes that underwent cataract surgery by FLACS in 38 eyes and by phacoemulsification in the remaining 32 eyes over the past 5 years, with nuclear cataract grades II-IV. Preoperative astigmatism ranged from ± 0.50 to 5.50 D in both groups and was managed with Toric IOL implantation. Barrett True-K and SRK/T were used to calculate IOL power. Follow-up ranged from 1 to 4 years.

RESULTS

Incomplete Rhexis, Inadequate Nucleotomy, and wound dehiscence were noted constraints in both groups. The mean postoperative uncorrected visual acuity (LogMAR) was 0.23 ± 0.09 in the PHACO group (n = 32), 0.22 ± 0.06 in the FLACS group (n = 38), and 0.22 ± 0.08 in the combined group, with a P value of 0.885. Residual astigmatism or spherical error ranged from plus or minus 0.75 to 3.25 dioptres. The FLACS group had a higher mean astigmatism correction (1D) than the phacoemulsification group (0.25D), attributable to precision in incision, rhexis, Nucleotomy, and rotational stability of the Toric IOL implant.

CONCLUSIONS

The Barrett True-K formula provided better predictive accuracy for the presumed IOL power than SRK/T in these cases. Both groups showed statistically significant improvement after FLACS or phacoemulsification, with slightly better outcomes after FLACS with laser energy modulation.