Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery (FLACS). In current research, we evaluated optical quality recovery and distinct macular thickness changes after FLACS and phacoemulsification cataract surgery (PCS). Methods: A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and

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... nctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation,1 week and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions preoperatively and1month after the surgery. Results: In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI ( p <0.0001), PSF (strehl ratio, SR) ( p= 0.027) and MTF ( p =0.028), but not intraocular pressure (IOP) ( p =0.857). The differences between pre-operation and post-operation for DLI ( p =0.031), SR ( p =0.01) and IOP ( p =0.03), but not MTF ( p =0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 ( p =0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group at 1month. In PCS group, we found the differences between pre-operation and post-operation in nasal inter macular ring thickness (NIMRT) ( p =0.03), foveal volume (FV) ( p =0.034) and average retinal thickness (ART) ( p =0.025) but not FLACS group at 1month. Conclusion: FLACS is safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast, PCS can produce macular thickness 4 changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.