• Xinyi Chen, Yinhui Yu, Xiaohui Song, Yanan Zhu, Wei Wang, and Ke Yao.
• From the Eye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
• J Cataract Refract Surg. 2017 Apr 1; 43 (4): 486-491.

PurposeTo compare the outcomes between femtosecond laser-assisted cataract surgery (femtosecond group) and conventional phacoemulsification cataract surgery (conventional group) in patients with hard nuclear cataract.SettingEye Center, Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China.DesignProspective consecutive nonrandomized comparative cohort study.MethodsAccording to the Emery-Little classification, cataract patients with a grade 4 or 5 hard nuclei were assigned to 1 of the 2 groups. The endothelial cell density (ECD), central corneal thickness (CCT), and uncorrected and corrected (CDVA) distance visual acuities were evaluated preoperatively and 1 day, 1 week, 1 month, and 3 months postoperatively.ResultsThe study comprised 95 eyes (47 in the femtosecond group; 48 in the conventional group). The effective phacoemulsification time, absolute phaco time, and mean ultrasound power were lower in the femtosecond group (P < .001, P = .001, and P < .001, respectively). The ECD in the conventional group was lower and the changes in endothelial cell loss was different between the 2 groups throughout the follow-up (both P < .001). The CCT increased after surgery, and the thickness was greater in the conventional group at 1 day postoperatively (P < .05); it then returned to preoperative levels 1 month postoperatively in the femtosecond group and at 3 months in the conventional group. The CDVA was stable by 1 month postoperatively in the femtosecond group and by 3 months in the conventional group.ConclusionCompared with conventional phacoemulsification, femtosecond laser-assisted cataract surgery for hard nuclear cataracts conserved phacoemulsification power, provided a significant reduction in corneal endothelial damage, and led to faster visual rehabilitation.Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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