Outcomes Of Femtosecond Laser-assisted Cataract Surgery Versus Conventional Phacoemulsification Surgery In Diabetic Cataract Patients

PurposeTo compare the outcomes after femtosecond laser-assisted cataract surgery or conventional phacoemulsification surgery in diabetes patients.MethodsThis a prospective cohort study.Diabetes patients who accepted femtosecond laserassisted cataract surgery or conventional phacoemulsification surgery at the Second Affiliated Hospital of Zhejiang University at the duration from June 2020 to November2020 were collected.The changes of endothelial cell density,central corneal thickness,coefficient of variation,the percentage of hexagonal cells,macula thickness and best corrected visual acuity were recorded and compared.ResultsA total of 190 patients were included in this study,92 patients in FLACS group and98 patients in CPS group.In FLACS group,there were 37 males and 55 females with an average age of 69.52±10.17 years and average diabetes history of 8.90±6.70 years;In CPS group,there were 38 males and 60 females with an average age of 70.30±7.10 years and average diabetes history of 8.29±6.82 years.ECD decreased significantly in both groups.However,ECD in FLACS group was significantly higher than CPS group at the timing of 1 week after surgery(2311.38±484.98 vs 2096.36±619.03,P<0.05).The ECD loss rates of FLACS group were significantly lower than CPS group at the timing of 1 week(11.71±15.56% vs21.22±22.32%,P<0.05)and 1 month(9.77±14.88% vs 20.40±20.33%,P<0.05)after surgery.As for the coefficient of variation and the percentage of hexagonal cells,there was no significant difference between these two groups at any timing after surgery.CCT increased significantly in both groups.The difference between two groups was significant at 1 week after surgery(544.23±28.00 vs 557.18±33.17,P<0.05).At the timing of 1 month and 3 months after surgery,there was no significant difference between these two groups.CRT,CV and CAT were not significantly different between two groups at any timing after the surgery,except lower CAT of group FLACS(277.77±29.70 vs286.33±31.39,P<0.05)at the follow-up timing of 1 month.The best corrected visual acuity(presented as log MAR)of FLACS group was significantly better than CPS group(0.13±0.29 vs 0.29±0.49,P<0.05).However,there was no difference between these two groups at the timing of 1 month and 3 months after surgery.ConclusionsComparing to CPS,FLACS decreased cornea endothelial cell loss and central corneal edema in diabetic cataract patients.FLACS can also improve the early visual outcomes,but the effect of decreasing macular thickness was not significant.