Comparison of macular parameters after femtosecond laser-assisted and conventional cataract surgery in age-related macular degeneration

J Cataract Refract Surg. 2018 Jan;44(1):23-27. doi: 10.1016/j.jcrs.2017.09.030. Epub 2018 Feb 1.

Abstract

Purpose: To evaluate differences in postoperative central macular thickness, central macular volume, corrected distance visual acuity (CDVA), and number of intravitreal anti-vascular endothelial growth factor (VEGF) injections between conventional and femtosecond laser-assisted cataract surgery in wet age-related macular degeneration (AMD).

Setting: Tertiary referral center, Lucerne, Switzerland.

Design: Retrospective case series.

Methods: Consecutive patients with AMD and cataract were enrolled between January 2010 and December 2015. Associations between postoperative changes in central macular thickness, central macular volume, CDVA, and number of anti-VEGF injections with type of surgery were assessed statistically.

Results: The study comprised 140 eyes (110 patients). No differences in postoperative central macular thickness (-9.20 μm; 95% confidence interval [CI], -41.68 to 23.28; P = .576), central macular volume (-0.08 mm2; 95% CI, -0.36 to 0.19; P = .553), visual acuity (0.03 logarithm of the minimum angle of resolution; 95% CI, -0.09 to 0.15; P = .647) or postoperative number of anti-VEGF injections (0.30; 95% CI, -0.45 to 1.05; P = .427) were found between the femtosecond laser group and the conventional group over a mean follow-up of 619 days ± 473 (SD). In the 33 eyes that had optical coherence tomography measurement within a postoperative period of 2 weeks, the central macular volume was significantly lower in femtosecond laser-treated eyes (-0.71 mm2; 95% CI, -1.19 to -0.23; P = .005).

Conclusions: Overall, the postoperative course between wet AMD after femtosecond laser and conventional cataract surgery was equal. During the early follow-up, femtosecond laser-treated eyes had less subclinical macular edema, indicating a possible benefit for patients with macular vulnerability.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cataract / complications*
  • Cataract Extraction / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy / methods*
  • Macula Lutea / pathology*
  • Male
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Visual Acuity*
  • Wet Macular Degeneration / complications
  • Wet Macular Degeneration / diagnosis*