This study compared femtosecond laser time, cumulative dissipated energy (CDE), effective phacoemulsification time (EPT), fluid perfusion volume, and changes in corneal endothelial cell quantity in short-axial-length cataract patients treated with LenSx and Catalys femtosecond laser systems. A single-center, prospective, randomized controlled trial included 100 eyes of short axial length patients. They were randomly assigned to different femtosecond laser pretreatment protocols before cataract phacoemulsification and intraocular lens (IOL) implantation. Data like age, LOCS III grade, and corneal endothelial counts were collected. The two groups had similar preoperative features. Except for femtosecond laser time, there were no statistically significant differences in CDE, EPT, fluid perfusion, and corneal endothelial counts. There were no significant differences in complication rates between the two groups. LenSx had more capsule edge problems, while Catalys might affect surgeons. Catalys exhibited shorter laser times in softer cataracts and greater variability in denser cases. LenSx demonstrated stable laser performance across cataract densities. These observations suggest the potential for tailored device selection for short-axial-length patients, but confirmation requires subgroup analyses with larger sample sizes.
Keywords: Capsulorhexis; Cataracts; Corneal endothelium; Femtosecond laser; Short axial length.