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Femtosecond laser-assisted cataract surgery in eyes after vitrectomy

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Session Details

Session Title: Cataract Surgery Outcomes / Femto

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 09:00

Venue: Auditorium

First Author: : A.Usov RUSSIA

Co Author(s): :    S. Sakhnov   E. Leksutkina           

Abstract Details

Purpose:

To determine the possibility of femtosecond laser assisted cataract surgery in eyes after vitrectomy.

Setting:

FSBI “The Academician S.N. Fyodorov IRTC “Eye Microsurgery” of the Ministry of Public Health of the Russian Federation, Krasnodar Branch

Methods:

Femtosecond laser assisted cataract surgery (FSACS) was performed in 4 cases at different terms after vitrectomy (VE). In one case VE with internal limiting membrane peeling and perfluorocarbon (PFC) short-term tamponade was performed in patient with macular hole of 4th stage. In 3 cases VE was made for retinal detachment (RD) treatment with tamponade and following removal of silicone oil. Femtolaser stage of the operation was carried out on the LenSx system in spite of such contraindications to FSASC as presence of various substances in the anterior chamber and the lens instability. Using femtolaser the anterior rhexis of 5.5-6.0 mm, 4 radial lines of lens separation and central circle with diameter of 3.1 mm were performed. Three-stage corneal flap 2.0 - 2.2 mm and 2 paracentesis 1.0-1.3 mm were carried out with the femtosecond laser assistance also. Phaco of the lens fragments by the standard technology was performed as the next step. In the lack of vitreal support and zonular weaknesses deep anterior chamber was observed in 2 cases during phaco. In one case existing PFC- bubble was aspirated from the anterior chamber. In all cases the intracapsular IOLs were implanted.

Results:

There weren’t any intraoperative or postoperative complications. The presence of PFC - bubble in the anterior chamber didn’t affect to the course of the femtolaser stage. Early postoperative period was areactive. The results were observed retrospectively till 3 months. Endothelial cells loss was less than 6%. The central retinal thickness wasn’t increased more than 20 microns by OCT, compared with the pre-operative period. There weren’t any redetachments. The visual acuity in each case depended on the individual initial functional state of the retina.

Conclusions:

Femtosecond laser assisted cataract surgery in eyes after VE is possible. The PFC in the anterior chamber and the lens instability did not have any affect to the tactic choice, but on the contrary, allowed to reduce ultrasound energy influence to the lens and retina in vitrectomized eyes. The application of femtolaser allowed to perform cornea incisions and capsularhexis with high accuracy as well as to ensure the maximum postoperative functional result.

Financial Interest:

NONE

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