Purpose
To compare the refractive and visual outcome after implantation of Lentis MPlus (Oculentis) multifocal intraocular lens (IOL) when applying LENSAR femtosecond laser for capsulotomy and crystalline lens fragmentation versus performing these steps manually by a single surgeon (who performs >800 cataract surgeries per annum).
Methods
In a retrospective analysis the outcome of 110 consecutive patients who underwent IOL implantation after manual capsulorrhexis and standard phacoemulsification were compared to the surgeon’s first (SAQ) 110 consecutive patients who underwent IOL implantation using LENSAR for femtosecond laser assisted capsulotomy and crystalline lens fragmentation. The multifocal Lentis Mplus MF30 or MF15 IOL was implanted in all patients.<br />
Results
Patient demographics were similar between groups. Two patients planned to have LENSAR femtosecond cataract surgery were converted to standard manual capsularrhexis with phacoemulsification due to inability to dock the patient interface on the ocular surface (one case of severe conjunctival chemosis following subtenons local anaesthesia and one case with very narrow palpebral aperture). Pre-operative spherical equivalent in the LENSAR group was 0.26 ± 4.17D (range, -11.8D to +9.25D) and in the Non-LENSAR group was -0.22 ± 3.97D (range, -15.25D to +6.88D). Post-operative spherical equivalent in the LENSAR group was -0.23 ± 0.45 D and in the Non-LENSAR group was -0.07 ± 0.38 D(p>0.05). Unaided distance visual acuity post-operatively was 0.10 ± 0.19 logMAR in the LENSAR group and 0.07 ± 0.17 logMAR in the Non-LENSAR group (p>0.05). Post-operative best-corrected distance visual acuity was 0.01 ± 0.13 logMAR in the LENSAR group and 0.00 ± 0.14 logMAR in the Non-LENSAR group (p>0.05). There were no recorded complications of surgery or post-operative adverse events in either group.
Conclusions
The surgeon’s first cases of LENSAR femtosecond laser assisted refractive lensectomy provide good results for post-operative refraction and distance visual acuity equivalent to manual phako lensectomy in a high volume cataract surgeon. No additional risk of complications was observed in the patients undergoing femtosecond assisted cataract surgery compared to manual cataract surgery.