Postoperative IOL Axial Movements and Refractive Changes After Femtosecond Laser-assisted Cataract Surgery Versus Conventional Phacoemulsification

J Refract Surg. 2015 Aug;31(8):524-30. doi: 10.3928/1081597X-20150727-02.


Purpose: To evaluate intraocular lens (IOL) axial movements and refractive changes during a 6-month follow-up period after femtosecond laser-assisted cataract surgery and conventional cataract surgery, investigate the influence of capsulorhexis features on postoperative IOL axial changes, and assess the prediction error for both techniques.

Methods: Eighty eyes of 80 candidates for cataract extraction were randomized into two groups: femtosecond laser (40 eyes) and manual (40 eyes).

Results: The overall anterior chamber depth variation was significantly lower in the femtosecond laser group compared to the manual group during follow-up (P<.001). At 30 and 180 days postoperatively, the mean spherical equivalent showed a hyperopic shift (0.09±0.28 diopters [D]) in the femtosecond laser group and a myopic shift in the manual group (-0.25±0.18 D). Median absolute error was not significantly different between the two groups with standard formulas ranging between 0.29 and 0.64 (Hoffer Q) in the femtosecond laser group and between 0.24 (SRK-T) and 0.55 D (Hoffer Q) in the manual group. There was a significant lower deviation from intended versus achieved capsulotomy/capsulorhexis area in the femtosecond laser group (P<.001) compared to the manual group. The femtosecond laser group showed better IOL centration compared to the manual group at all time periods (P<.001).

Conclusions: Femtosecond laser-assisted cataract surgery was related to a lower overall variability of anterior chamber depth compared to conventional cataract surgery with more stable postoperative refraction. The two techniques did not show significant differences of prediction error.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anterior Chamber / pathology
  • Artificial Lens Implant Migration / etiology
  • Artificial Lens Implant Migration / physiopathology*
  • Cataract Extraction*
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy / methods*
  • Lens Implantation, Intraocular
  • Lenses, Intraocular*
  • Male
  • Phacoemulsification / methods*
  • Postoperative Complications*
  • Prospective Studies
  • Pseudophakia / physiopathology
  • Refraction, Ocular / physiology
  • Refractive Errors / etiology
  • Refractive Errors / physiopathology*
  • Visual Acuity / physiology