Comparative Study of Femtosecond Laser Assisted and Traditional Phacoemulsification Combined with Toric Intraocular Lens Implantation in the Treatment of Cataract
Objective To compare the clinical effects of femtosecond laser assisted cataract surgery and traditional phacoemulsification combined with Toric intraocular lens(IOL)implantation in the treatment of cataract.Methods A to-tal of 48 patients with normal axial cataract(22 mm ≤ axial length＜24 mm)in author's hospital were randomly divided into femtosecond group(n=16)and traditional group(n=32)according to random number table method.The best cor-rected visual acuity(BCVA)and distribution of astigmatism were observed before and after the surgery,strchl,surface asymmetry index(SAI),surface regularity index(SRI),spherical aberration(SA),irregular astigmatism index(IAI)and higher order aberrations were measured by OPD-SCANⅢ visual quality analyzer,the TOPCON KR-1W visual quality ana-lyzer was used to detect the 3rd-order aberrations within a 4 mm pupil(4s3),4th-order aberrations within a 4 mm pupil(4s4),total aberrations within a 4 mm pupil(4Total),3rd-order aberrations within a 6 mm pupil(6s3),4th-order aberrations within a 6 mm pupil(6s4),5th-order aberrations within a 6 mm pupil(6s5),6th-order aberra-tions within a 6 mm pupil(6s6),the sum of 3rd and 5th-order aberrations within a 6 mm pupil(6s3+s5),the sum of 4th and 6th-order aberrations within a 6 mm pupil(6s4+s6)and total aberrations within a 6 mm pupil(6Total).Cor-relation analysis was also performed among postoperative corneal indices and higher order aberrations and strchl.Results Three months after surgery,the BCVA in the femtosecond group was(0.06±0.07)logMAR,and in the tradi-tional group was(0.16±0.21)logMAR,both showing significant improvement compared to preoperative levels(P＜0.05).The astigmatism distribution 3 months after surgery was(0.83±0.53)D in the femtosecond group and(0.67±0.46)D in the traditional group,both significantly reduced compared to those before surgery(P＜0.05).The compari-son of BCVA,astigmatism distribution and strchl values between the two groups 3 months after surgery showed no sta-tistically significant differences(all P＞0.05).Three months after surgery,in the femtosecond group,the strchl value was negatively correlated with corneal Total aberrations and negatively correlated with intraocular Total,High aberrations(P＜0.05);in the traditional group,the strchl value was negatively correlated with corneal s3+s5+s7 aberrations and negatively correlated with whole-eye High,s3+s5+s7 aberrations(P＜0.05).There were no statistically significant differences in corneal and whole-eye higher order aberrations after surgery between the two groups(all P＜0.05).Three months after surgery,in the femtosecond group,the strchl value was negatively correlated with whole-eye 4s3,4s4 and 4Total aberrations(P＜0.05);in the traditional group,the strchl value was negatively correlated with whole-eye 4s3,4s4 and 4Total aberrations,as well as with 6s3,6s4,6s6,6s3+s5,6s4+s6 and 6Total(P＜0.05).Conclusion Cataract surgery assisted by femtosecond laser and traditional phacoemulsification combined with the implan-tation of Toric IOL are both effective in treating cataract.For cataract patients with regular corneal astigmatism,femto-second laser-assisted cataract surgery combined with the implantation of Toric IOL is safe and effective.It not only treats the cataract but also corrects the patient's corneal astigmatism.Maintaining the centration of the Toric IOL in the capsu-lar bag,preventing tilting of the IOL optical surface and reducing surgically induced damage are prerequisites for ensuring postoperative visual quality.
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