title: Clinical outcomes in the first two years of femtosecond laser-assisted cataract surgery.
abstract: OBJECTIVE
  To analyze outcomes of femtosecond laser cataract surgery cases in the first 2 years in an ophthalmic institution.
  
  
  METHODS
  Nonrandomized treatment comparison with matched, historical controls.
  
  
  METHODS
  Outcomes and intraoperative events of all laser cataract surgeries (5.0- to 5.5-mm-diameter laser capsulotomies and nuclear fragmentation) at the Singapore National Eye Centre (May 2012-December 2013) were prospectively audited. The 6-weeks-postoperative unaided visual acuities (UAVA), mean absolute error (MAE), mean square error (MSE), and manifest refraction spherical equivalent (MRSE) results of surgeons with >50 laser cases were compared with controls, a random sample of manual cases with similar age, axial length, and preoperative cylinders. Statistical analysis was performed with SPSS (P < .05).
  
  
  RESULTS
  A total of 1105 eyes (803 patients) underwent laser cataract surgery by 18 surgeons. The majority were female (56.9%) and Chinese (90.9%) with mean age 66.1 ± 11.0 years. Intraoperative complications were subconjunctival hemorrhage (290, 26.2%), anterior capsule tear (9 eyes, 0.81%), posterior capsule rupture (3 eyes, 0.27%), suction loss (5 eyes, 0.45%), iris hemorrhage (1 eye, 0.09%), and endothelial incision (1 eye, 0.09%). There was no dropped nucleus. Visual outcomes of 794 laser surgeries were compared to 420 controls. The %UAVA 20/25 or better was higher in laser cases (68.6% vs 56.3%; P < .0001) but MAE (0.30 ± 0.25 diopter [D] vs 0.33 ± 0.25; P = .062) and MSE (0.16 ± 0.27 D vs 0.17 ± 0.28 D; P = .065) were not significant. MRSE comparison was significant (target plano, preoperative cylinder <1.5 D -0.08 ± 0.36 D vs -0.13 ± 0.40 D; P = .034).
  
  
  CONCLUSIONS
  Femtosecond laser cataract surgery has a low complication rate. Cases compared to controls had statistically better %UAVA ≤20/25 and MRSE, although MAE was not significant.
authors: Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore. Electronic address: chee.soon.phaik@snec.com.sg.
authors: Soon-Phaik
authors: SP
authors: Chee
authors: Singapore National Eye Centre, Singapore.
authors: Younian
authors: Y
authors: Yang
authors: Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore.
authors: Seng-Ei
authors: SE
authors: Ti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D002648:Child; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D053685:Laser Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*