Efficacy and Safety of Femtosecond Laser-Assisted Cataract Surgery with the Catalys Platform in Patients with Type 2 Diabetes and Cataract: A Prospective Cohort Study.

INTRODUCTION

In recent years, the continuous rise in diabetes prevalence has led to a significant increase in the number of patients with diabetic cataracts. Femtosecond laser-assisted cataract surgery (FLACS), as an innovative technology in the field of cataract treatment, has demonstrated remarkable advantages over conventional phacoemulsification (CPS) in terms of surgical precision and efficiency. However, the unique ocular pathological changes in patients with diabetes (such as fragile lens capsules, posterior synechiae of the iris, and increased risk of postoperative inflammatory reactions) pose distinct challenges for cataract surgery. Currently, there is a lack of evidence-based medical data regarding the safety and efficacy of FLACS in this specific population.

METHODS

In this prospective study, 87 patients with diabetic cataract were randomized to the CPS (n = 46) and FLACS group (n = 41). Baseline characteristics and postoperative outcomes (central macular thickness [CMT], corneal thickness [CT], best-corrected visual acuity [BCVA], aqueous prostaglandin E2 [PGE2]) were analyzed. A non-diabetic control group (n = 40) underwent identical evaluations, including pupil size measurement.

RESULTS

Baseline characteristics showed no significant differences between groups (p > 0.05). FLACS and CPS groups demonstrated comparable CMT and CT at all time points (preoperative, 1 week, 1 month, 3 months), although both groups showed increased values postoperatively versus baseline (p < 0.05). The FLACS group achieved significantly better BCVA at 1-day postoperative assessment (p < 0.05) and exhibited higher aqueous PGE2 levels (p < 0.05). Patients with diabetic cataract and non-diabetic cataract had similar anatomical and visual outcomes (p > 0.05), but diabetics maintained higher postoperative PGE2 levels following FLACS (p < 0.05). No significant difference in pupil diameter was observed between the two groups (p > 0.05).

CONCLUSION

FLACS showed comparable safety to CPS with faster visual recovery but higher PGE2 in patients with diabetic cataract, requiring close postoperative monitoring.