{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:44:15Z","timestamp":1792712655574,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate change in retinal layers 18\u2009months after femtosecond laser\u2010assisted cataract surgery (LCS) and manual cataract surgery (MCS) in a representative age\u2010related cataract population using artificial intelligence (AI)\u2010based automated retinal layer segmentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, randomized and intraindividual\u2010controlled study including 60 patients at the Medical University of Vienna, Austria. Bilateral same\u2010day 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\u2010operatively and up to 18\u2009months post\u2010operatively in the central 1\u2009mm, 3\u2009mm and 6\u2009mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010six patients completed all follow\u2010up visits. LCS compared to MCS did not impact any of the investigated retinal layers at any follow\u2010up visit (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). For the central 1\u2009mm, a significant increase in total retinal thickness (TRT) was seen after 1\u2009week followed by an elevated plateau thereafter. For the 3\u2009mm and 6\u2009mm, TRT increased only after 3\u2009weeks and 6\u2009weeks and decreased again until 18\u2009months. TRT remained significantly increased compared to pre\u2010operative thickness (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). 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\u2009week after surgery but regained pre\u2010operative values 18\u2009months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low\u2010energy femtosecond laser pre\u2010treatment did not influence thickness of the retinal layers in any topographic zone compared to manual high fluidic phacoemulsification. TRT did not return to pre\u2010operative values 18\u2009months after surgery. The causative layers for subclinical development of CME were successfully identified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.16667","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T09:38:50Z","timestamp":1709631530000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010term impact of <scp>low\u2010energy<\/scp> femtosecond laser and manual cataract surgery on macular layer thickness: A prospective randomized study"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-5736","authenticated-orcid":false,"given":"Luca","family":"Schwarzenbacher","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Optometry Medical University of Vienna  Vienna 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Optometry Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7646-8804","authenticated-orcid":false,"given":"Christina","family":"Leydolt","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-7082","authenticated-orcid":false,"given":"Rupert","family":"Menapace","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7661-4015","authenticated-orcid":false,"given":"Gregor S.","family":"Reiter","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Optometry Medical University of Vienna  Vienna Austria"},{"name":"Laboratory 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