Evaluation of macular pigment optical density following femtosecond laser-assisted cataract surgery

Abstract

Tommaso Verdina,1 Purva Date,2 Caterina Benatti,1 Andrea Lazzerini,1 Elisa Fornasari,1 Michele De Maria,3 Elena Pellacani,1 Matteo Forlini,4 Gian Maria Cavallini11Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy; 2Aditya Jyot Eye Hospital, Mumbai, India; 3Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; 4Domus Nova Hospital, Ravenna, ItalyBackground: To evaluate macular pigment optical density (MPOD) after bimanual femtosecond laser-assisted cataract surgery (FLACS) compared to standard bimanual phacoemulsification (B-MICS).Methods: A prospective, case matched, comparative cohort study conducted at the Institute of Ophthalmology, University of Modena and Reggio Emilia (Italy); 30 eyes underwent bimanual FLACS with low-energy Ziemer LDV Z8 (FLACS) and 30 underwent B-MICS standard technique (B-MICS). All interventions were conducted by the same expert surgeon. MPOD using the Macular Pigment Screener II (MPS II) was evaluated at baseline, 7 and 30 days after surgery. As secondary outcomes, we considered best corrected visual acuity (BCVA) and central macular thickness (CMT) obtained using optical coherence tomography.Results: In all cases, a BunnyLens AF IOL was safely implanted in the capsular bag through a 1.4 mm incision. We found a significant reduction in MPOD in both groups at 7 and 30 days; 0.16±0.14 and 0.10±0.12 (FLACS) and 0.18±0.13 and 0.15±0.14 (B-MICS), respectively (P<0.05). However, there was no significant difference between the two groups at either 7 (P=0.52) or 30 days (P=0.18). BCVA improved significantly in both groups and CMT increased in both groups (P<0.001, P<0.001, respectively). BCVA and CMT were similar between the groups with a significant difference in CMT in favor of the FLACS group at 30 days (P=0.017).Conclusions: MPOD was reduced in both groups without any significant difference between the FLACS and B-MICS cataract interventions. FLACS is associated with a significantly higher increase of macular thickness at 30 days compared to B-MICS.Keywords: femtosecond laser, macular pigment, macular pigment optical density (MPOD), femtosecond laser-assisted cataract surgery (FLACS), bimanual microincision cataract surgery (B-MICS), flicker photometr