Effect of femtosecond laser-assisted cataract surgery for cataracts after pars plana vitrectomy: A prospective randomized controlled study

Abstract

Objective: To compare the efficacy of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification (CPS) in treating cataracts after vitrectomy. Methods: This was a prospective randomized controlled study. Patients who underwent cataract surgery after pars plana vitrectomy (PPV) were randomly divided into the FLACS group and the CPS group. Preoperative data from all patients were collected, and the intraoperative average phacoemulsification energy (AVE), effective phacoemulsification time (EPT), intraoperative complications, postoperative intraocular pressure, corneal endothelial cell density (ECD), and best corrected visual acuity (BCVA) were compared. Results: A total of 92 eyes were included in the analysis, with 47 eyes in the FLACS group and 45 eyes in the CPS group. Compared with those in the CPS group, the intraoperative AVEs and EPTs in the FLACS group were lower (P < 0.05). In the FLACS group, 3 eyes (3/47, 6.38%) had incomplete presplitting nuclei, 3 eyes (3/47, 6.38%) had incomplete capsulotomy, and 1 eye (1/47, 2.13%) had incomplete lens dislocation. In the CPS group, 2 eyes (2/45, 4.44%) had incomplete lens dislocation, and 1 eye (1/45, 2.22%) had a radial anterior capsule tear. There was no statistically significant difference in intraoperative complications between the two groups (P > 0.05). Compared with before surgery, both groups presented a decrease in intraocular pressure (IOP), and there was no statistically significant difference in IOP between the two groups three months after surgery (P > 0.05). Three months after surgery, the ECD of the FLACS group was greater than that of the CPS group, and the average endothelial cell loss (ECL) was lower than that of the CPS group (P < 0.01). Both groups showed varying degrees of improvement in the postoperative BCVA compared with the preoperative BCVA. On the first day after surgery, the FLACS group was superior to the CPS group (P < 0.05), while there was no statistically significant difference between the two groups at one week, one month, three months after surgery (all P > 0.05). Conclusion: Postoperative complications of nuclear cataract after PPV should be promptly treated with surgery. FLACS is safe and effective in treating cataracts after PPV surgery, providing faster visual improvement and facilitating the postoperative recovery of cataracts after PPV surgery.