Comparison of macular parameters after femtosecond laser-assisted and conventional cataract surgery in age-related macular degeneration

Purpose: To evaluate differences in postoperative central macular thickness, central macular volume, corrected distance visual acuity (CDVA), and number of intravitreal anti-vascular endothelial growth factor (VEGF) injections between conventional and femtosecond laser assisted cataract surgery in wet age-related macular degeneration (AMD). Setting: Tertiary referral center, Lucerne, Switzerland. Design: Retrospective case series. Methods: Consecutive patients with AMD and cataract were enrolled between January 2010 and December 2015. Associations between postoperative changes in central macular thickness, central macular volume, CDVA, and number of anti-VEGF injections with type of surgery were assessed statistically. Results: The study comprised 140 eyes (110 patients). No differences in postoperative central macular thickness (-9.20 mu m; 95% confidence interval [CI], -41.68 to 23.28; P=.576), central macular volume (-0.08 mm(2); 95% CI, 0.36 to 0.19; P=.553), visual acuity (0.03 logarithm of the minimum angle of resolution; 95% CI, -0.09 to 0.15; P=.647) or postoperative number of anti-VEGF injections (0.30; 95% CI, -0.45 to 1.05; P=.427) were found between the femtosecond laser group and the conventional group over a mean follow-up of 619 days +/- 473 (SD). In the 33 eyes that had optical coherence tomography measurement within a postoperative period of 2 weeks, the central macular volume was significantly lower in femtosecond laser treated eyes (-0.71 mm(2); 95% CI, -1.19 to -0.23; P=.005). Conclusions: Overall, the postoperative course between wet AMD after femtosecond laser and conventional cataract surgery was equal. During the early follow-up, femtosecond laser treated eyes had less subclinical macular edema, indicating a possible benefit for patients with macular vulnerability.