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First Author: M.Naveiras SPAIN
Co Author(s): C. Lisa J. Alfonso L. Fernández-Vega
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To demonstrate how femtosecond laser technology can increase safety in extreme cataract surgery: Shallow anterior chamber, very hard cataract (nigra), subluxated lens, and IOL exchange with narrow capsulorhexis. Four illustrative cases are described.
Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
Subjects comprised 4 eyes that underwent phacoemulsification aided with cataract femtosecond laser (LensX, Alcon; Catalys, Optimedica) to ensure predictable 4.8mm continuous circular capsulorhexis (CCC). In all cases, Morcher Capsular tension rings were implanted prior to the IOL to stabilize the bag and improve predictability of the estimated lens position. Case 1. Medium cataract with an anterior chamber depth of 1.22 mm (endothelium-lens). Case 2. Hard nigra cataract with high myopia. Stable CCC and nucleus fragmentation. Case 3. Subluxated and tilted lens with 1.67mm to the endothelium. CCC was offset to the real center of the lens. Then stabilized with capsular tension ring and iris hooks. Case 4. In-the bag IOL exchange with a narrow (<3.0mm), fibrosed CCC. Enlarged to 4.8mm without damaging the bag integrity.
All cases were successfully treated with the laser and predictable 4.8mm were attained. Cataracts were then phacoemulsified and IOLs implanted in the bag without complications.
Cataract surgery aided by femtosecond laser technology can successfully undertake extreme cases in which manual capsulorhexis would have been severely encumbered.