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Zonulysis following femtosecond laser-assisted cataract surgery

Poster Details

First Author: H.Lin SINGAPORE

Co Author(s):    B. Lim   C. Ngo                 

Abstract Details


To describe our experience in dealing with intra-operative zonulysis following femtosecond laser assisted capsulorrhexis creation and lens fragmentation with the Catalys�â�„�¢ in seemingly normal eyes.


Department of Ophthalmology National University Hospital, Singapore


Retrospective review of femtosecond assisted cataract surgeries performed over a year, with complications of intra-operative zonulysis. 3 patients who had uneventful femtosecond laser assisted capsulorrhexis creation and lens fragmentation with the Catalys�â�„�¢ under topical anaesthesia were identified. There was no suspicion of pre-operative zonulysis on clinical examination in any of the patients. All three patients were noted to have significant lens tilt, with at least 3 clock hours of zonulysis noted during the early stages of surgery, after release of the air bubble.


In all three patients, decision was made to convert the surgery to intracapsular cataract extraction and anterior chamber intraocular lens implantation. Our patients had an uneventful post-operative recovery, with good visual outcomes of at least 6/12 at post-operative month 3.


There have been many reports on the success of femtosecond assisted cataract surgery. However, in our experience, we have encountered several challenges as well, such as significant zonulysis after application of the femtosecond laser. We postulate that in these patients, there was likely pre-existing, mild and clinically in apparent zonulysis, which could have been exaggerated following femtosecond laser due to stretching of the capsular bag secondary to gas formation. In addition, performing the recommended step of gas removal could put additional strain on the compromised zonules, with resultant significant zonulysis.

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