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Purpose: To evaluate change in retinal layers 18 months after femtosecond laser‐assisted cataract surgery (LCS) and manual cataract surgery (MCS) in a representative age‐related cataract population using artificial intelligence (AI)‐based automated retinal layer segmentation. Methods: This was a prospective, randomized and intraindividual‐controlled study including 60 patients at the Medical University of Vienna, Austria. Bilateral same‐day LCS and MCS were performed in a randomized sequence. To provide insight into the development of cystoid macular oedema (CME), retinal layer thickness was measured pre‐operatively and up to 18 months post‐operatively in the central 1 mm, 3 mm and 6 mm. Results: Fifty‐six patients completed all follow‐up visits. LCS compared to MCS did not impact any of the investigated retinal layers at any follow‐up visit (p > 0.05). For the central 1 mm, a significant increase in total retinal thickness (TRT) was seen after 1 week followed by an elevated plateau thereafter. For the 3 mm and 6 mm, TRT increased only after 3 weeks and 6 weeks and decreased again until 18 months. TRT remained significantly increased compared to pre‐operative thickness (p < 0.001). Visual acuity remained unaffected by the macular thickening and no case of CME was observed. Inner nuclear layer (INL) and outer nuclear layer (ONL) were the main causative layers for the total TRT increase. Photoreceptors (PR) declined 1 week after surgery but regained pre‐operative values 18 months after surgery. Conclusion: Low‐energy femtosecond laser pre‐treatment did not influence thickness of the retinal layers in any topographic zone compared to manual high fluidic phacoemulsification. TRT did not return to pre‐operative values 18 months after surgery. The causative layers for subclinical development of CME were successfully identified. [ABSTRACT FROM AUTHOR]

Background: We evaluated whether the best‐fit intraocular lens (IOL) power formula for the first operated eye (BF1) was also the most accurate formula for the second eye. Methods: This was a retrospective study of 152 patients who underwent uncomplicated delayed bilateral cataract surgery with a minimum delay of 3 weeks using only one 1‐piece IOL (HOYA, Vivinex) at the Medical University of Vienna, Austria. Seven different formulae (Barrett Universal II, Castrop, Haigis, Hoffer Q, Holladay 1, Kane, and SRK/T) were investigated to test the formula selection approach with regard to the calculated mean and median absolute prediction errors (MAE/MedAE). Results: The mean intraindividual difference in axial length was 0.2 mm (±0.3 mm). BF1 coincided with the best‐fit formula for the second eye (BF2) in 56% of patients (p < 0.05). Using BF1 for the second eye led to a lower MedAE (0.22 dioptre, D) than using a formula at random (0.33 D) and was less accurate than using the best‐fit formula for each eye separately (0.1 D). The MedAEs of all formulae were generally low, ranging from 0.28 to 0.35 D. Conclusion: Using BF1 for the second eye led to a lower MedAE than the random selection of a formula. Therefore, BF1 can be used for the second eye if the surgeon is unsure of the choice of formula. [ABSTRACT FROM AUTHOR]