Femtosecond laser in congenital cataract

Session Details

Session Title: Moderated Poster Session 04: Special Cases on Cataract Surgery: Paediatric

Session Date/Time: Tuesday 13/09/2016 | 14:00-15:00

Paper Time: 14:00

Venue: Poster Village: Pod 1

First Author: : G.Vizzari ITALY

Co Author(s): :    P. Bordin              

Abstract Details

Purpose:

The aim of this study is to describe a technique for performing cataract surgery with a femtosecond laser (FLACS) in infants with bilateral polar cataract, using a viscoelastic substance to visualize the posterior capsule.

Setting:

Department of Ophthalmology, Hospital of Legnago, Verona

Methods:

A 2-year-old male presented with bilateral polar cataract. His best-corrected visual-acuity(BCVA)was 20/200(OD) and 20/100(OS).He underwent bilateral FLACS(Victus,B&L)followed by implantation of a intraocular lens(IOL). Anterior capsulotomy of 5 mm is performed by the laser.The eye has been opened for lens aspiration.A hole is created in the posterior capsule using a 27G-needle and filled a short-chains-viscoelastic device through the gap in the vitreal chamber,between the posterior capsula and the hyaloid.The real time-integrated optical-coherence-tomography also visualizes the posterior capsule pushed up by the viscoelastic,allowing a centered central posterior capsulotomy of 4.5 mm,followed by mechanical anterior-vitrectomy. A IOL is implanted in the bag.

Results:

The child was followed up on day 1, day 5, at 2 weeks, 4 weeks and 8 weeks. At each follow-up visit, complete ocular examination including slit-lamp biomicroscopy and orthoptic examination of both eyes were performed. The corneal were clear and the intraocular pressure (IOP), recorded by Perkins applanation tonometer, were 15 mmHg in OD and 16mmHg in OS at every visit. At 4 weeks the BCVA was 20/30 in OU. Anterior and posterior capsulotomies were complete and uniform, without tears or tags. The IOL was centered in the capsular bag. No complications were encountered.

Conclusions:

The technique has been performed in a infant with congenital cataract and it can enhance the quality of pediatric cataract surgery. Anterior and posterior capsulotomies are difficult steps in the cataract surgery in infants and children.The capsule is very elastic and tends to tear peripherally in manual anterior capsulotomy.This can induce to complete loss of the capsule protection during surgery, with damage of the capsular scaffold for the IOL placement. Using the viscoelastic to push up the capsule allow a better visualization of the capsular surface,in order to standardize the capsulotomy procedure and to obtain a safe,precise and repetitive surgery.

Financial Disclosure:

NONE