Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification surgery: visual outcomes with presbyopia-correcting intraocular lens.

PURPOSE: To compare the visual outcomes between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) combined with presbyopia-correcting intraocular lens (IOL) implantation.

METHODS

A retrospective cohort study was conducted. Patients who underwent cataract surgery with presbyopia-correcting IOL implantation at Dongguan Guangming Ophthalmic Hospital between April 2023 and December 2025 were enrolled and divided into FLACS and CPS groups. Follow-up examinations were performed at 1 day and 1 month postoperatively. Uncorrected and corrected distance, intermediate, and near visual acuity (VA), spherical equivalent (SE), defocus curve, high-order aberrations (HOAs), spherical aberration, coma, trefoil, modulation transfer function (MTF), and Strehl ratio (SR) were evaluated and compared between the two groups. All outcomes were reported in accordance with international standards for reporting cataract surgery outcomes.

RESULTS

This study included 134 eyes from 134 patients, with 67 patients assigned to each group. The mean UDVA was 0.26 in the FLACS group and 0.33 in CPS group at 1 day postoperatively (p = 0.049). At 1 month postoperatively, all patients achieved favorable uncorrected and corrected VA at distance, intermediate, and near, alongside a significant improvement in overall visual quality compared to preoperative values (p < 0.001). The FLACS group demonstrated a postoperative uncorrected distance VA of 0.08 ± 0.07 logMAR, compared to 0.07 ± 0.08 logMAR in the CPS group (p > 0.05). The FLACS group exhibited better performance of functional VA at intermediate distance. The defocus curves of the FLACS group showed better and more stable full-range vision. Areas under the uncorrected defocus curve of FLACS and CPS groups were 1.26 and 1.18, respectively.

CONCLUSION

Both FLACS and CPS can effectively improve VA and significantly enhance visual quality after presbyopia-correcting IOL implantation. Compared to CPS, FLACS exhibited enhanced full-range vision, more stable intermediate and near vision, as well as certain advantages in early recovery of VA.