Research Article - Journal of Clinical Ophthalmology (2025) Volume 9, Issue 1

Comparison of Choroidal Thickness After Standard Phacoemulsification versus Femtosecond Laser Assisted Surgery: A Systematic Review and Meta-Analysis

Purpose: To investigate changes in choroidal thickness post-cataract surgery at 1-week, 1-month, and 3-months following phacoemulsification versus femtosecond laser assisted cataract surgery (FLACS). Methods: The PubMed and EMBASE databases were searched from inception until March 2024. All relevant studies comparing choroidal thickness (CT) before and after cataract surgery were retrieved and filtered. Results: A total of 29 studies including 2084 eyes were included. There was no significant change in CT at 1-week (P=.29), 1-month (P=.54), and 3-months (P=.91) after phacoemulsification, nor following FLACS at 1-week (P=.80), 1-month (P=.77), and 3-months (P=.71). In subgroup analysis, the CT of patients with diabetes mellitus (DM) at 3-months (but not at 1-week (P=.22) or 1-month (P=.31)) was significantly thicker than before surgery (MD=8.90, 95% CI: 1.55-16.25, P=.02). Patients of Caucasian ethnicity had significantly thicker CT (P<.001) at 1-week and 1-month (both P<.001) post-operatively but not at 3-months (P=.49). No difference in CT compared to baseline was observed in Asians 1-week (P=.97), 1-month (P=.87) and 3-months (P=.83) post-operatively. Reduction of topical anti-inflammatory medication 1-week post-operatively resulted in thicker CT in DM patients at 3-months (MD=8.90, CI=1.55-16.25, P=.008), and in non-DM patients at 1-month (MD=0.73, CI=-1.61-3.06, P<.001) and 3-months (MD=-0.13, CI=-2.22-1.97, P<.001). Conclusion: CT did not significantly increase in eyes 1-week, 1-month, and 3-months after either phacoemulsification or FLACS. Patients with DM and of Caucasian ethnicity were more likely to have thicker CT post-operatively. Reduction of topical anti-inflammatory post-operatively was associated with an increase in CT.

Author(s):

Barry Moses Quan Ren Koh^{1, 2,3} , Wei Kiong Ngo^1,3,4 , Rupesh Agrawal ^1,3,4 , Bryan Chin Hou Ang^1,3,4,5

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