Effectiveness, Stability and Influence Factors of Femtosecond Laser Assisted Cataract Surgery

Study Description for General Audience

What's the problem? Many people with cataracts also have an irregularly curved front surface of the eye (called astigmatism). After cataract surgery, this astigmatism can still cause blurry or distorted vision, making everyday tasks like reading or driving difficult. While glasses or special lenses can help, many hope to reduce their dependence on them after surgery.

What's being tested?

This study evaluates a laser procedure called Femtosecond Laser-Assisted Arcuate Keratotomy (FSAK). During cataract surgery:

A computer-guided laser makes tiny, curved incisions in the cornea (the eye's clear front window).

These precise incisions gently reshape the cornea to improve its natural curve. Think of it like a sculptor smoothing uneven surfaces-but using light-speed technology.

Why is this study unique?

While FSAK isn't brand new, the investigators lack long-term data on:

How the investigatorsll it holds up over 5+ years. Which factors predict success (e.g., does participantsr eye's shape or pressure affect results?).

the investigators're following participants for 5 years to ansthe investigatorsr these questions-far longer than most existing studies.

What will participants experience?

Surgery: FSAK is combined with standard cataract removal. The laser step adds only minutes.

Follow-ups: Painless check-ups at 1 the investigatorsek, 1 month, 3 months, 6 months, 1 year, 2 years, and 5 years after surgery. These involve:

Reading eye charts. Quick scans to map the eye's surface. Short questionnaires about vision quality (e.g., glare at night or reading small print).

Why does this matter?

If successful, FSAK could:

• Help people see clearly longer after cataract surgery.
• Reduce the need for glasses or contacts.
• Give doctors better tools to personalize treatment.

Who's involved?

Led by eye specialists at Fudan University Eye & ENT Hospital and Shanghai Peace Eye Hospital.

Inclusion criteria

• Age: 20-80 years
• Age-related cataracts
• Regular corneal astigmatism (0.75-2.0 diopters) confirmed by Pentacam/IOLMaster 700
• Surgical Plan: Scheduled for femtosecond laser-assisted cataract surgery
• Central corneal thickness ≥500 µm
• Endothelial cell count ≥2,000 cells/mm²
• Best-corrected visual acuity (BCVA) improvable to ≥20/40

Exclusion criteria

• Prior corneal refractive surgery (e.g., LASIK, PRK)
• Intraocular surgery (e.g., glaucoma filtering surgery)
• Irregular astigmatism (keratoconus, scarring, post-traumatic distortion)
• Active ocular inflammation or infection
• Corneal endothelial disease (e.g., Fuchs' dystrophy)
• Severe dry eye (Schirmer test ≤5 mm/5 min)
• Uncontrolled glaucoma (IOP >21 mmHg on medication)
• Macular pathology (e.g., AMD, DME affecting visual potential)
• Amblyopia
• Autoimmune diseases affecting cornea (e.g., rheumatoid arthritis, Sjögren syndrome)
• Diabetes mellitus with retinopathy
• Pregnancy/Lactation
• Inability to complete 5-year follow-up