Photo Credit: Ogtay Mammadov

The following is a summary of “Assessment of intraocular lens tilt and decentration after femtosecond laser-assisted and conventional cataract surgery at 12 months and beyond,” published in the October 2024 issue of Ophthalmology by Kim et al. 

Researchers conducted a retrospective study to compare long-term intraocular lens (IOL) decentration and tilt after femtosecond laser-assisted cataract surgery (FLACS) vs conventional surgery using swept-source anterior segment optical coherence tomography (SS-ASOCT).  

They examined patients who underwent either FLACS or conventional cataract surgery. Patients with a follow-up of 12 months post-surgery were included, while those with surgical complications were excluded. Data collected included demographics, preoperative ocular measurements (axial length and anterior chamber depth), and postoperative measurements such as corrected distance visual acuity (CDVA), autorefraction, keratometry, and IOL type. Postoperative IOL tilt and decentration were compared between patients who underwent FLACS and those who had conventional cataract surgery using SS-ASOCT. A subgroup analysis examined tilt and decentration based on haptic type (single piece vs 3-piece).  

The results showed that a total of 188 eyes were included, with 110 eyes (58.5%) in the FLACS group and 78 eyes (41.5%) in the conventional group. No significant differences were found between the FLACS and conventional groups concerning preoperative parameters, FLACS resulted in reduced IOL decentration compared to conventional cataract surgery, measuring 170 μm vs 240 μm (P = 0.002). There were no significant differences between the 2 groups regarding the magnitude and axis of IOL tilt, with both groups showing a tendency for IOL tilt toward the inferotemporal aspect. Furthermore, no differences were noted in postoperative CDVA, spherical equivalent, or keratometric astigmatism.  

Investigators concluded that FLACS resulted in better long-term IOL centration compared to conventional surgery with manual capsulotomy, while no significant differences in IOL tilt or postoperative CDVA were observed between the techniques. 

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03720-2