Objective:To evaluate the effect of femtosecond laser-assisted relaxing arcuate keratotomy in cataract surgery for coma correction on improving postoperative visual quality.Methods:This was a prospective case-control study. A total of 60 eyes of 51 cases with cataract from Jan. to Dec. 2018 in Shanghai Heping Eye Hospital were collected in the study. All cases were randomly divided into two groups, the trial group with 30 eyes and the control group with 30 eyes. The trial group received femtosecond laser assisted phaco & relaxing arcuate keratotomy. The control group underwent conventional femtosecond laser assisted phaco. Corneal astigmatism and 3mm coma under the pupils were scanned through iTrace at 3 months after surgery. The modulation transfer function (MTF) values and Strehl rate (SR) of the full eye were concluded. Total high-order aberration of the whole eye at 3mm and 6mm were measured in the meantime. The follow-up time was 3 months after surgery.Results:Corneal coma and astigmatism after surgery decreased in the trial group ( t=15.50, P<0.05). Visual quality analysis of patients after cataract surgery: there were significant differences between the trial group and the control group in corneal astigmatism [(0.277±0.100) D, (1.257±0.246) D], coma 0.046±0.026, 0.181±0.060, MTF (0.381±0.096, 0.248±0.105) and SR (0.100±0.023, 0.067± 0.023) values after cataract surgery( P<0.05). The difference in HOA in the examination of 6mm under the pupils was statistically significant ( P<0.05). Conclusion:Femtosecond laser-assisted relaxing arcurate keratotomy for coma correction can improve the visual quality significantly after cataractsurgery.

AIM:To investigate the influences of Nd:YAG laser capsulotomy with different size on visual acuity(VA), intraocular pressure(IOP), refraction, anterior chamber depth(ACD), and macular thickness(MT)in patients with posterior capsular opacification(PCO). METHODS: In this retrospective, constantly study, 41 eyes of 41 patients treated with Nd:YAG laser posterior capsulotomy for PCO were divided into 2 groups according to the different incision sizes of capsulotomy: the patients received capsulotomy with the incision diameter less than or equal to 3.5mm were enrolled into group 1, while those received operation with incision diameter more than 3.5mm went to group 2. All patients were followed up before Nd:YAG laser capsulotomy, 1wk, 1 and 3mo after Nd:YAG laser capsulotomy, and the best-corrected visual acuity(BCVA), refraction, IOP, ACD, and MT were compared between two groups. RESULTS: In both groups, BCVA were significantly improved postoperatively compared with base line(P<0.001), but there was no significant difference between two groups(P>0.05). The diopter(SE)of the two groups were not significantly different before and after operation(P>0.05). Intraocular pressure in group 2 was higher than those in group1 at 1wk(t=-2.609, P=0.013). ACD decreased significantly at 1wk postoperatively(P<0.01), but with no significant difference at 1 and 3mo(P>0.05). Both groups had increased macular thickness lightly at 1wk postoperatively, but with no statistical significance(P>0.05), and there was no significant difference between the two groups at 1wk, 1 and 3mo postoperatively(P>0.05). CONCLUSION: The increase in intraocular pressure is more pronounced when the size of posterior capsulotomy was larger. However, the changes of BCVA, ACD, refraction, MT are not related with the incision size of posterior capsulotomy.