A prospective observational cohort study has found that femtosecond laser-assisted cataract surgery and conventional phacoemulsification produce distinct short-term trajectories in choroidal thickness, vascularity, and choriocapillaris perfusion. The investigation, published in BMC Ophthalmology by Ruolin Li and colleagues, evaluated structural and perfusion changes to address limited comparative evidence regarding how these two surgical modalities impact the choroid during the first month of recovery.
The single-center study evaluated 62 eyes from 62 patients who underwent either femtosecond laser-assisted cataract surgery (31 eyes) or conventional phacoemulsification (31 eyes). Researchers collected swept-source optical coherence tomography angiography measurements prior to surgery and at three scheduled postoperative follow-up intervals: postoperative day 1, postoperative week 1, and postoperative month 1.
Intraoperative surgical metrics showed marked differences between the two procedures. Conventional phacoemulsification required significantly longer total ultrasound time than femtosecond laser-assisted cataract surgery (P = 0.006) and resulted in significantly higher cumulative dissipated energy (P < 0.001).
Longitudinal changes in subfoveal choroidal thickness, choroidal vascularity index, and choriocapillaris perfusion area were analyzed using mixed-design repeated-measures analysis of variance with Bonferroni adjustment for pairwise comparisons within each surgical group. Statistically significant time-by-group interactions were identified across all three evaluated metrics: subfoveal choroidal thickness (P < 0.001), choroidal vascularity index (P = 0.001), and choriocapillaris perfusion area (P = 0.001).
In the femtosecond laser-assisted group, subfoveal choroidal thickness decreased at postoperative day 1, the choroidal vascularity index increased at postoperative day 1 and week 1, and the choriocapillaris perfusion area increased at postoperative week 1 relative to baseline (all adjusted P < 0.05). By postoperative month 1, none of these parameters in the laser-assisted cohort differed significantly from preoperative levels. In contrast, all three parameters in the conventional phacoemulsification cohort remained significantly elevated above baseline across all postoperative visits (all adjusted P < 0.05). The authors concluded that the clinical significance of these divergent postoperative trajectories warrants further investigation.
Subject of Research: Short-term choroidal changes following femtosecond laser-assisted versus conventional cataract surgery
Article Title: Short-term choroidal changes after femtosecond laser-assisted cataract surgery and conventional phacoemulsification: a prospective observational cohort study
Article References: Li, R., Hua, X., Wei, X., Wang, H., Pan, D., Liu, X., & Yuan, X. (2026). Short-term choroidal changes after femtosecond laser-assisted cataract surgery and conventional phacoemulsification: a prospective observational cohort study. BMC Ophthalmology. https://doi.org/10.1186/s12886-026-05515-z
Image Credits: AI Generated
DOI: 10.1186/s12886-026-05515-z
Keywords: cataract surgery, femtosecond laser-assisted cataract surgery, phacoemulsification, choroidal thickness, choroidal vascularity index, choriocapillaris perfusion area, swept-source OCTA, ophthalmology, Short-term, choroidal, changes, femtosecond
News Source: Ophelia Keating. (November 6, 2026). Laser-Assisted and Conventional Cataract Surgeries Show Distinct Short-Term Choroidal Trajectories. Scienmag.
