Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 1;31(5):340-345.
doi: 10.1097/IJG.0000000000002014. Epub 2022 Mar 18.

Effect of Femtosecond Laser Cataract Surgery on Peripapillary Retinal Nerve Fiber Layer Thickness

Orna Geyer  1 , Or Ben-Shaul  1 , Chen Lux  1 , Sharon Schwartz  1 , Olga Podkovyrin  1 , Nili Stein  2 , Idit Lavi  2 , Nurit Mathalone  1
Affiliations

Effect of Femtosecond Laser Cataract Surgery on Peripapillary Retinal Nerve Fiber Layer Thickness

Orna Geyer et al. J Glaucoma. .

Abstract

Prcis: Femtosecond laser-assisted cataract surgery (FLACS) may cause thinning of the peripapillary retinal nerve fiber layer (pRNFL) in healthy eyes.

Purpose: This prospective cohort study aimed to compare changes of pRNFL after FLACS using a liquid patient interface and conventional phacoemulsification cataract surgery (CPCS).

Patients and methods: Included were 261 eyes (261 patients) with age-related cataracts and no ocular diseases scheduled either for FLACS (222 eyes) or CPCS (39 eyes). FLACS was performed using a Ziemer LDV Z8 laser. Average and quadrant pRNFL thickness was measured using optical coherence tomography before surgery and at 1, 3, and 6 months postoperatively. Postoperative changes in pRNFL thickness were compared within and between groups.

Results: Mean quadrant and average pRNFL thicknesses significantly increased after both surgeries (P<0.001). However, pRNFL thinning occurred after FLACS and CPCS (17% vs. 5.1%, respectively, P>0.05). FLACS eyes showed a significant and stable decrease of average pRNFL thickness (P=0.057) and a gradual decrease in pRNFL thickness of all quadrants (P≤0.018). CPCS eyes showed an initial increase of pRNFL thickness, followed by a decrease only in the nasal quadrant and average pRNFL. Preoperative pRNFL thickness was associated with thinning of the temporal quadrant (P=0.04).

Conclusions: Both FLACS and CPCS demonstrated pRNFL thinning in some healthy eyes. Although the higher rate of pRNFL thinning after FLACS compared with CPCS lacked statistical significance, a consistent decrease in pRNFL thickness occurred in all quadrants and average pRNFL of FLACS eyes, suggesting that FLACS may lead to pRNFL thinning. Eyes with thinner preoperative pRNFL may be prone to temporal quadrant thinning after FLACS.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Kerr NM, Abell RG, Vote BJ, et al. Intraocular pressure during femtosecond laser pretreatment of cataract. J Cataract Refract Surg. 2013;39:339–342.
    1. Baig NB, Cheng GPM, Lam JKM, et al. Intraocular pressure profiles during femtosecond laser-assisted cataract surgery. J Cataract Refract Surg. 2014;40:1784–1789.
    1. Darian-Smith E, Howie AR, Abell RG, et al. Intraocular pressure during femtosecond laser pretreatment: comparison of glaucomatous eyes and nonglaucomatous eyes. J Cataract Refract Surg. 2015;41:272–277.
    1. De Giacinto C, D’Aloisio R, Bova A, et al. Intraocular pressure changes during femtosecond laser-assisted cataract surgery: a comparison between two different patient interfaces. J Ophthalmol. 2019;2019:5986895.
    1. Tatham A, Medeiros F. Detecting structural progression in glaucoma with optical coherence tomography. Ophthalmology. 2017;124:S57–S65.

Publication types