Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification Combined with Vitrectomy for Cataract Complicated with Fundus Disease: Superior Efficacy in Patients with Vitreous Opacity and Cost-Effectiveness Analysis.

AIM: To compare the efficacy of femtosecond laser assisted cataract surgery (FLACS) combined with pars plana vitrectomy (PPV) and conventional phacoemulsification surgery (CPS) combined with PPV in the treatment of cataract patients with fundus diseases.

METHODS

A retrospective analysis was conducted on 379 affected eyes from Shanghai Aier Eye Hospital from 01/02/2022 to 01/02/2025, divided into group A (n=182, 48%, FLACS+PPV) and group B (n=197, 52%, CPS+PPV), to compare surgical costs, best corrected visual acuity (BCVA), complications, and surgical time.

RESULTS

Postoperative visual acuity improved significantly in both groups (all P < 0.0001). For vitreous opacity (VO) patients, the BCVA improvement in group A (0.34±0.51) was significantly better than that in group B (0.15±0.52, P=0.03), with a shorter surgical time (45.22±8.15 vs 52.72±7.17 min, P < 0.0001) and lower complication rate (7.14% vs 11.68%). Overall, group A had a shorter surgical time (47.75±10.06 vs 59.22±11.6 min, P < 0.0001) and better postoperative BCVA (0.36±0.45 vs 0.49±0.48, P=0.0001) than group B, but higher surgical costs (21,600±9180 vs 15,399±2996 yuan, P < 0.0001).

CONCLUSION

FLACS+PPV has excellent therapeutic effects but is expensive, while CPS+PPV has a high cost-effectiveness, and clinical selection should be based on the patient's condition.