AIM: To compare the effectiveness and safety of femtosecond laser-assisted cataract surgery(FLACS)with traditional cataract surgery in cataract patients with different axial lengths.

METHODS: Patients with cataract surgery were divided into normal axis group(22mm≤AL<24mm group), medium and long axis group(24mm≤AL <26mm), and long axis group(26mm≤AL)according to the axial length. Each group had 100 eyes. The patients in each group were randomly divided into femtosecond laser group and traditional ultrasonography group. The postoperative changes of best-corrected visual acuity(BCVA), visual quality and corneal endothelial cells were analyzed.

RESULTS: The visual acuity of the patients in each group was improved(FLACS: t=8.29, 25.01, 19.23, all P<0.01; PHACO: t=19.61, 18.76, 18.23, all P<0.01). Visual acuity improvement after FLACS in different axial groups was better than that after PHACO, but there was no significant difference between the groups(P=0.24, 0.25, 0.19). The postoperative strehl ratio value increased after operation in all groups expect for PHACO medium and long axis group, but the increase was significant only in normal axis group(P=0.011, 0.007). The corneal endothelial counts in the FLACS group were significantly lower than those before the operation(P<0.01, 0.002, <0.01). The corneal endothelial counts in the PHACO group except for the medium and long axis group were significantly reduced after surgery(P<0.01); there was no significant difference in postoperative corneal endothelial count between the FLACS and PHACO groups(P>0.05).

CONCLUSION: Both traditional cataract surgery and femtosecond laser-assisted cataract surgery can effectively improve the BCVA in various types of axis. Both surgical methods will cause damage to the corneal endothelium, but the difference is not obvious.