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. 2023 Jan 1;49(1):55-61.
doi: 10.1097/j.jcrs.0000000000001027. Epub 2022 Aug 31.

Comparative visual outcomes of EDOF intraocular lens with FLACS vs conventional phacoemulsification

Jia Xu  1 , Wenbo Li, Zhe Xu, Binsong Zhao, Yueyang Zhong, Kai Wang, Xin Liu, Xiaohui Song, Yinhui Yu, Yanan Zhu, Qiaomei Tang, Ke Yao
Affiliations

Comparative visual outcomes of EDOF intraocular lens with FLACS vs conventional phacoemulsification

Jia Xu et al. J Cataract Refract Surg. .

Abstract

Purpose: To investigate the visual quality after femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) with the implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) TECNIS Symfony.

Setting: Eye Center, the Second Affiliated Hospital of Zhejiang University, Zhejiang, China.

Design: Prospective cohort study.

Methods: Patients were given the option to choose FLACS or CPS and were implanted with a TECNIS Symfony. Main outcome measures were postoperative examinations that included defocus curves, contrast sensitivity (CS), optic path difference aberrometry scan, anterior segment photography, and questionnaires.

Results: 261 patients (261 eyes) were enrolled. The circularity index of FLACS was more precise than that of CPS ( P = .001). FLACS demonstrated a significantly lower IOL decentration ( P = .011) and IOL tilt ( P = .009). FLACS presented a significantly lower total aberration ( P < .001), higher-order aberrations (HOAs) ( P = .001), coma ( P = .001), and spherical aberration ( P < .001). With IOL decentration of more than 0.40 mm, total internal aberration ( P = .023) and HOAs ( P = .045) were significantly deteriorated. As for defocus curve, FLACS was better at -1.00 diopter ( P < .01). The FLACS group achieved higher CS at 6 to 18 cycles per degree under glare condition ( P < .05). With regard to photic phenomena, the FLACS group received better outcomes ( P < .05).

Conclusions: With the implantation of an EDOF IOL, FLACS could precisely control the shape and size of the capsulotomy and induce a significantly better-centered IOL, leading to higher visual performance compared with CPS.

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Figures

Figure 1.
Figure 1.
Distribution of IOL decentration in the total sample.
Figure 2.
Figure 2.
Effect of tilt on aberrations of total aberrations (A), HOAs (B), coma (C), and spherical aberration (D) with the pupil diameter of 5.0 mm.
Figure 3.
Figure 3.
Defocus curves after IOL implantation between the Femto and the Phaco groups (A) and the groups divided separately with IOL decentration (B) or tilt (C). <0.4 mm = IOL decentration <0.40 mm; ≥0.4 mm = IOL decentration ≥0.40 mm; <0.25 μm = tilt <0.25 μm; ≥0.25 μm = tilt ≥0.25 μm. **P < .01.
Figure 4.
Figure 4.
Contrast sensitivities with and without glare under mesopic condition after IOL implantation. *P < .05; **P < .01.
See this image and copyright information in PMC

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