Neodymium:YAG capsulotomy rates associated with femtosecond laser-assisted versus manual cataract surgery

PURPOSE: To compare the neodymium:YAG posterior capsulotomy rates after cataract surgery performed using a femtosecond laser system versus manual techniques. SETTING: Pacific Hills Surgery Center, Laguna Hills, and La Veta Surgery Center, Orange, California, USA. DESIGN: Retrospective case study. METHODS: After surgeries were completed between August 2011 and August 2014. A corrected distance visual acuity (CDVA) of 20/25 or better 1 to 3 months after surgery was identified in a chart review and analyzed. Intraocular lens (IOL) type and power were recorded. Capsulotomies were recorded with the date of the procedure and the precapsulotomy CDVA. Capsulotomy rates related to manual capsulorhexis and capsulorhexis with a femtosecond laser system were compared, with consideration of IOL design and material. RESULTS: There was no statistically significant difference in posterior capsule opacification grade between surgery groups (P =.13). Capsulotomy rates were significantly lower in the femtosecond laser-assisted cataract surgery group than in the manual group (P = .04). The time between surgery and capsulotomy was statistically significantly lower in the femtosecond laser assisted cataract surgery group (P < .01), which appeared to be a function of the higher ratio of multifocal IOLs in that group. There was a lower overall capsulotomy rate with hydrophobic acrylic IOL material than with hydrophilic IOL material. CONCLUSIONS: Neodymium:YAG capsulotomy rates were lower with femtosecond laser assisted cataract surgery than with manual cataract surgery. The differences were more apparent in IOL material and design groups in which overall capsulotomy rates were lower.