Please use this identifier to cite or link to this item: https://doi.org/10.3389/fmed.2021.811093
Title: Randomized Controlled Trial Comparing 1-Year Outcomes of Low-Energy Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification
Authors: Liu, Yu-Chi 
Setiawan, Melina
Chin, Jia Ying
Wu, Benjamin
Ong, Hon Shing 
Lamoureux, Ecosse 
Mehta, Jodhbir S. 
Keywords: aqueous profiles
clinical outcomes
conventional phacoemulsification
low-energy femtosecond laser-assisted cataract surgery
patient-reported outcomes
randomized controlled trial
Issue Date: 17-Dec-2021
Publisher: Frontiers Media S.A.
Citation: Liu, Yu-Chi, Setiawan, Melina, Chin, Jia Ying, Wu, Benjamin, Ong, Hon Shing, Lamoureux, Ecosse, Mehta, Jodhbir S. (2021-12-17). Randomized Controlled Trial Comparing 1-Year Outcomes of Low-Energy Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification. Frontiers in Medicine 8 : 811093. ScholarBank@NUS Repository. https://doi.org/10.3389/fmed.2021.811093
Rights: Attribution 4.0 International
Abstract: Purpose: To compare 1-year clinical outcomes, phacoemulsification energy, aqueous profiles, and patient-reported outcomes of low-energy femtosecond laser-assisted cataract surgery (FLACS) vs. conventional phacoemulsification. Methods: The study is a randomized controlled trial (RCT) with paired-eye design. Eighty-five patients were randomized to receive FLACS (Ziemer LDV Z8) in one eye and conventional phacoemulsification in the fellow eye. Clinical data including phacoemulsification energy parameters (cumulative dissipated energy, phacoemulsification power, and phacoemulsification time), uncorrected and corrected distance visual acuities (UCDVA and BCDVA), manifest refraction spherical equivalent (MRSE), central corneal thickness (CCT), endothelial cell count (ECC), anterior chamber flare, and post-operative complications were obtained for 1 year. Aqueous humor was collected for the analysis of prostaglandin (PGE)2, cytokines and chemokines concentrations. Patients' reported-outcomes on surgical experiences were evaluated using an in-house questionnaire. Results: Compared to conventional phacoemulsification, the low-energy assisted FLACS group had significantly less ECC reduction at 3 months (1.5 ± 0.3% vs. 7.0 ± 2.4%; P < 0.01) and 1 year (8.2 ± 2.8% vs. 11.2 ± 3.6%; P = 0.03). There were no significant differences in the phacoemulsification energy parameters, UCDVA, BCDVA, MRSE, CCT, occurrence of post-operative complications between the 2 groups throughout post-operative 1 year. Patients' subjective surgical experiences, including the surgical duration and perceived inconvenience, were comparable between the 2 groups. FLACS resulted in significantly higher aqueous PGE2 (P < 0.01), interleukin (IL)-6 (P = 0.03), IL-8 (P = 0.03), and interferon (IFN)-? (P = 0.04) concentrations and greater anterior chamber flare at 1 day (P = 0.02). Conclusions: Our RCT presented 1-year longitudinal clinical and laboratory data. The long-term ECC result was more favorable in low-energy FLACS. The rest of the intraoperative and post-operative outcomes, as well as patient-reported outcomes, were comparable between these two procedures. Copyright © 2021 Liu, Setiawan, Chin, Wu, Ong, Lamoureux and Mehta.
Source Title: Frontiers in Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/232264
ISSN: 2296-858X
DOI: 10.3389/fmed.2021.811093
Rights: Attribution 4.0 International
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