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A Comparison of Refractive Accuracy Between Conventional and Femtosecond Laser Cataract Surgery Techniques Using Modern IOL Formulas

Authors Connell BJ, Kane JX, Vajpayee RB

Received 6 December 2020

Accepted for publication 15 February 2021

Published 2 March 2021 Volume 2021:15 Pages 899—907

DOI https://doi.org/10.2147/OPTH.S296032

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Benjamin J Connell,1,2 Jack X Kane,2 Rasik B Vajpayee2– 4

1Eye Surgery Associates, Melbourne, Victoria, Australia; 2Corneal Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; 3Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia; 4Vision Eye Institute, Melbourne, Victoria, Australia

Correspondence: Benjamin J Connell
Eye Surgery Associates, 2/232 Victoria Pde, East Melbourne, VIC, 3002, Australia
Tel +61 9416 0695
Fax +61 9416 1816
Email [email protected]

Purpose: To compare the refractive outcome prediction accuracy between conventional (CCS) and femtosecond laser assisted (FLACS) cataract surgery techniques using optimized lens constants for modern intraocular lens (IOL) formulas.
Patients and Methods: Our retrospective, comparative, interventional case series, compared data from 196 eyes undergoing CCS and 456 eyes undergoing FLACS with Acrysof IOL (Alcon laboratories, Inc) implantation. After optimizing IOL constants, the predicted refractive outcome was calculated for all formulas for each case. This was compared to the actual refractive outcome to provide the prediction error. The performance of CCS and FLACS was compared by the absolute prediction error and percentage of eyes within 0.25D, 0.5D and 1.0D of anticipated refractive outcome.
Results: There was no statistically significant difference in median absolute error between the CCS and LACS groups for the Kane (0.256, 0.236; p=0.389), SRK T (0.298, 0.302, p=0.910), Holladay (0.312, 0.275; p=0.090), Hoffer Q (0.314, 0.289; p=0.330), Haigis (0.309, 0.258; p=0.177), Barrett Universal 2(0.250, 0.250; p=0.866), Holladay 2 (0.250, 0.258; p=0.860) and Olsen (0.260, 0.255; p=0.570) formulas. Similarly, there was no consistent difference between the two techniques for percentage of patients within 0.25, 0.50 and 1.0D of predicted refractive outcome for each formula.
Conclusion: There was no difference in refractive outcome prediction accuracy between the CCS and FLACS techniques.

Keywords: femtosecond laser-assisted cataract surgery, refractive predictability, IOL formulas

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