Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification Surgery: Clinical Outcomes with EDOF IOLs

In this study, we evaluate and compare the outcomes of conventional phacoemulsification cataract surgery (CPS) and femtosecond laser-assisted cataract surgery (FLACS) with the implantation of an extended depth of field (EDOF) intraocular lens (IOL). A prospective, consecutive cohort study was conducted. Patients were given the option to choose FLACS or CPS and were implanted with an EDOF IOL. Refractive data, visual acuity data, ocular aberration measured with a wavefront aberrometer, and optical quality measured with an optical quality analysis system II were collected at one month postoperatively. A total of 92 eyes of 64 patients were enrolled in this study; 35 eyes of 26 patients were treated with FLACS, whereas 57 eyes of 38 patients were treated with CPS. Uncorrected visual acuity at far, intermediate, and near distance and best-spectacle-corrected visual acuity were not statistically significantly different between the groups (all p > 0.05), nor were the mean cylinder and mean spherical equivalent refraction (both p > 0.05). The FLACS group had a lower ocular trefoil than the CPS group (p = 0.033), and there was no significant difference between the two groups considering other aberration parameters, whether ocular or internal (all p > 0.05). Optical-quality-related parameters showed also no significant difference between the two groups (all p > 0.05). In conclusion, there was no significant difference between FLACS and CPS with implantation of EDOF IOLs in postoperative ocular parameters, refractive outcomes, ocular aberration, optical quality, and aberration parameters, except a lower ocular trefoil in the FLACS group. In terms of these indicators, FLACS does not provide an additional clinical benefit for patients over CPS.