Effect of femtosecond laser-assisted cataract surgery for cataracts after pars plana vitrectomy: a prospective randomized controlled study

Objective To compare the efficacy of femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) in treating postvitrectomy cataracts. Methods Prospective randomized controlled study. Patients who underwent cataract surgery after pars plana vitrectomy (PPV) were randomly divided into the FLACS group and the CPS group. Preoperative data of all patients were collected to compare intraoperative complications, average phacoemulsification energy (AVE), effective phacoemulsification time (EPT), postoperative intraocular pressure, corneal endothelial cell density (ECD), and best corrected visual acuity (BCVA). Results A total of 92 eyes were included in the analysis, with 47 eyes in the FLACS group and 45 eyes in the CPS group. The intraoperative AVEs and EPTs in the FLACS group were both lower than those in the CPS group (P < 0.05). In the FLACS group, incomplete prechopping and incomplete capsulorhexis occurred in 3 eyes (3/47, 6.38%), and incomplete lens dislocation occurred in 1 eye (1/47, 2.13%). In the CPS group, incomplete lens dislocation occurred in 2 eyes (2/45, 4.44%), and anterior capsule tears occurred in 1 eye (1/45, 2.22%). There was no statistically significant difference in intraoperative complications between the two groups (P > 0.05). Postoperatively, intraocular pressure (IOP) was lower in both groups than preoperatively, and there was no statistically significant difference in intraocular pressure between the two groups at three months postsurgery (P > 0.05). Three months postoperatively, the ECD in the FLACS group was greater than that in the CPS group, with less average endothelial cell loss (ECL) than that in the CPS group (P < 0.01). The BCVA in both groups improved to varying degrees compared with the preoperative values, with the FLACS group performing better than the CPS group on the first postoperative day (P < 0.05). There was no statistically significant difference between the two groups at one week, one month, or three months postoperatively (all P > 0.05). Conclusion FLACS is safe and effective for treating post-PPV cataracts and, compared with CPS, facilitates early postoperative recovery with no difference in final visual acuity. Residual silicone oil in the anterior chamber post-PPV may lead to certain specific outcomes for FLACS. Although it may not affect surgical results, it is still noteworthy.