Postoperative Decline in Antioxidant Concentrations in Aqueous Humor: Comparison Between Femtosecond Laser-assisted Cataract Surgery and Conventional Cataract Surgery

To evaluate alterations in total antioxidant capacity (TAC) and ascorbic acid (AA) levels in femtosecond laser-assisted cataract surgery (FLACS) compared with conventional cataract surgery. A prospective non-randomized study was conducted wherein 18 and 36 patients undergoing FLACS and conventional cataract surgery, respectively, with the same phacoemulsification and femtosecond laser devices were enrolled. Samples of aqueous humor were obtained via paracentesis before and 1 day after the cataract surgery, and TAC and AA concentrations were determined. The generalized linear mixed model was adopted to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) of changes in TAC and AA between groups. The TAC and AA levels significantly decreased postoperatively in both groups (p=0.05). In the multivariate analysis, the trend in decline in TAC (aOR=0.352, 95% CI=0.218-0.527, p=0.0177) and AA (aOR=0.308, 95% CI=0.156-0.488, p=0.0204) was significantly lower in the FLACS group. In the subgroup analyses, the correlation between FLACS and smaller TAC reduction was more significant in patients with high myopia, dense cataract, short anterior chamber depth, and greater axial length (p<0.05). In addition, the correlation between FLACS and smaller reduction in AA was more significant in patients with high myopia, dense cataract, greater axial length, and greater central corneal thickness (p<0.05). Patients with high myopia and dense cataract may consider FLACS to reduce the possibility of oxidative stress-related postoperative complications.