BACKGROUND To compare the visual and refractive outcomes of femtosecond laser assisted cataract surgery (FLACS) using Victus platform (Technolas Bausch and Lomb (B&L), Munich, Germany) and conventional phacoemulsification cataract surgery (CPCS). METHODS A retrospective study of 100 eyes operated for cataract. FLACS was performed in 50 eyes and CPCS was done in another 50 eyes. Preoperative and 6 months postoperative visual and refractive evaluation (efficacy, safety, predictability, and surgically induced astigmatism) as well as higher-order aberrations were analyzed. Efficacy index which equals post-operative mean of uncorrected distance visual acuity (UDVA) divided by preoperative mean corrected distance visual acuity (CDVA) was calculated in both groups. Safety index equals post-operative mean of corrected distance visual acuity (CDVA) divided by preoperative mean CDVA. RESULTS Logarithm of the Minimum Angle of Resolution (LogMAR), UDVA improved in both groups after surgery (p < 0.05). It was 0.23 ± 0.20 and 0.291 ± 0.311 log MAR in FLACS and CPCS groups respectively. Safety index was 1.777 in FLACS group and 1.744 in CPCS groups showing high degree of safety of both measures. Mean surgically induced astigmatism (SIA) was 0.35 ± 0.67 D and 0.901 ± 0.882 D in FLACS and CPCS groups respectively (p = 0.015). The post-operative comparison between both groups was in favor of CPCS group vs. FLACS group regarding total aberrations (0.563 ± 0.386 vs. 0.91 ± 1.20) (p = 0.03), while low order aberrations were significantly less in FLACS group vs. CPCS group (0.64 + 0.63 vs. 2.07 + 3.15) (p = 0.027). RMS high order aberration was higher in FLACS group vs. CPCS group but of no statistical significance 0.54 ± 0.96 vs. 0.328 ± 0.360 (p = 0.082). CONCLUSION Femtosecond laser -assisted cataract surgery was a safe and precise procedure but enhanced visual outcomes only minimally when compared to conventional cataract surgery in experienced hands. Both FLACS and manual surgeries can achieve a high efficacy, predictability and safety with slight superior outcomes in FLACS. TRIAL REGISTRATION NUMBER PACTR201804003256258 (date: 27 Mar 2018) Available at: https://pactr.samrc.ac.za/.

中文翻译：

---

飞秒激光辅助白内障手术与标准超声乳化手术的屈光结果比较。


背景 比较使用 Victus 平台（Technolas Bausch and Lomb (B&L)，慕尼黑，德国）的飞秒激光辅助白内障手术 (FLACS) 和传统超声乳化白内障手术 (CPCS) 的视觉和屈光结果。方法 对 100 只因白内障手术的眼睛进行回顾性研究。对 50 只眼睛进行 FLACS，对另外 50 只眼睛进行 CPCS。分析术前和术后 6 个月的视力和屈光评估（有效性、安全性、可预测性和手术引起的散光）以及高阶像差。计算两组的疗效指数，等于术后平均未矫正远视力（UDVA）除以术前平均矫正远视力（CDVA）。安全指数等于术后平均矫正远视力 (CDVA) 除以术前平均 CDVA。结果 手术后两组的最小分辨率对数 (LogMAR)、UDVA 均有所改善 (p < 0.05)。 FLACS 组和 CPCS 组的 MAR 分别为 0.23 ± 0.20 和 0.291 ± 0.311 log MAR。 FLACS组的安全指数为1.777，CPCS组的安全指数为1.744，表明两种措施的安全性都很高。 FLACS 组和 CPCS 组的平均手术引起散光 (SIA) 分别为 0.35 ± 0.67 D 和 0.901 ± 0.882 D (p = 0.015)。两组术后的总像差比较显示 CPCS 组与 FLACS 组相比（0.563 ± 0.386 与 0.91 ± 1.20）（p = 0.03），而 FLACS 组与 CPCS 组相比，低阶像差明显减少组（0.64 + 0.63 对比 2.07 + 3.15）（p = 0.027）。 FLACS 组的 RMS 高阶像差高于 CPCS 组，但无统计学意义：0.54 ± 0.96 比 0.328 ± 0.360 (p = 0.082)。 结论 飞秒激光辅助白内障手术是一种安全、精确的手术，但与经验丰富的手进行的传统白内障手术相比，视力结果的改善程度很小。 FLACS 和徒手手术都可以实现较高的疗效、可预测性和安全性，并且 FLACS 的结果略胜一筹。试用注册号 PACTR201804003256258（日期：2018 年 3 月 27 日）可在以下网址获取：https://pactr.samrc.ac.za/。