Long-term visual field changes after femtosecond laser-assisted cataract surgery in glaucoma patients, case series

Abstract

Purpose To assess the short and long-term changes in Visual Field (VF) Mean Deviation (MD), Visual Field Index (VFI), and intraocular pressure (IOP) after femtosecond laser-assisted cataract surgery (FLACS) in glaucomatous eyes. Materials and methods Interventional, prospective case series. Patients with glaucoma, who required cataract surgery were included. All patients underwent a complete ophthalmologic assessment and Visual Fields. FLACS was performed in all patients by a single experienced surgeon. IOP was measured during surgery immediately before and after pretreatment suction docking. Changes from baseline in VF MD and VFI, IOP, visual acuity (VA), and number of glaucoma medications were evaluated up to one-year follow-up. Results Fourteen eyes of 11 patients were included. Eighty-five percent were female, with a mean age of 74.2 ± 7.9 years. Nine (64.3%) and 5 (35.7%) were diagnosed with primary angle closure glaucoma (PACG) and primary open angle glaucoma (POAG), respectively. We found a slight IOP reduction after the docking phase during FLACS in both glaucoma subtype groups. No significant changes in visual field mean deviation (MD) and visual field index (VFI) were found from baseline to 12 months after surgery in both groups. A significant reduction in IOP values was found in all cases from baseline up to one year follow up. No significant changes were observed in BCVA and number of topical glaucoma medications after one year in both groups. Conclusion In our patients, there was an IOP reduction immediately after suction docking FLACS pretreatment. Mean IOP at final follow-up showed a reduction from baseline. There was no change in VF MD and VFI from baseline to final one-year follow-up. FLACS appears to be well tolerated in early and moderate glaucoma and appears to be a safe tool for glaucoma patients undergoing cataract surgery. Similar results to traditional surgery can be obtained with the advantages of femtosecond laser precision.

Comparison of the actual diameter of capsulotomy and predicted diameter of capsulotomy after femtosecond laser–assisted capsulotomy

“…We also found that the DDC has no correlation with AL, ACD, or Km but has a negative correlation with LT, indicating that a thick preoperative LT led to a stable anterior capsulotomy size, possibly because the thicker lens had a higher capsular tension, which could decrease the elasticity of the capsulotomy; however, the correlation between the DDC and LT was weak, and when the FLACS technique was applied for some special patients, such as those whose AL was long or LT was thick, all PDCs were set to 5.0 mm with no special requirements when setting parameters, which is consistent with our research. [28][29][30][31] Therefore, we suggest that it may be unnecessary to consider the influence of ocular biometric factors when setting parameters in FLACS.…”

Femtosecond Laser-Assisted Ophthalmic Surgery: From Laser Fundamentals to Clinical Applications

“…The IOP returned to baseline levels after 1 week and the decrease in IOP persisted through 3 years in glaucoma patients [ 101 ]. No significant changes in visual field mean deviation and visual field index were found from the baseline to 12 months after surgery in glaucoma patients [ 102 ].…”