AIM: To compare the clinical observations of patients with cataract axis longer than 24mm who underwent either femtosecond laser or traditional cataract surgery combined with Toric intraocular lens.

METHODS: Prospective study. The subjects were patients with cataract eyes with axis length longer than 24mm who underwent ocular cataract surgery and toric IOL implantation in our hospital. They were divided into femtosecond phaco groups. Clinical observations included uncorrected visual acuity, best corrected visual acuity, and changes in corneal and intraocular high-order phase difference.

RESULTS: The best corrected visual acuity of the two groups 3mo after surgery(0.092±0.089, 0.131±0.096)was significantly higher than that before surgery(0.855±0.213, 0.948±0.135)(P<0.05). The difference between the high-order cornea and the entire eye of the two groups was not significant(P>0.05). In the femtosecond group, the strchl values were negatively correlated with 4s3, 4s4, and 4Total in the 4mm pupil diameter of the entire eye and with the 6s5 at 6mm pupil diameter. The strchl values were also negatively correlated with 4s3 and 4Total in the 4mm pupil diameter of the entire eye in the traditional group and with 6s3, 6s3+s5, and 6Total under the 6mm pupil diameter.

CONCLUSION: Implantation of Toric IOL in patients with cataract greater than 24mm can effectively correct corneal regular astigmatism. Both FLACS and conventional phacoemulsification can maintain intraocular rotational stability and significantly improve postoperative visual quality.