Irvine Gass Syndrome After Femtosecond-Laser Assisted Cataract Surgery

To report the Irvine-Gass Syndrome after Femtosecond-laser assisted cataract surgery

All surgeries were performed in the Dr Solomatin eye center, Riga, Latvia. 

The author presents the series of postoperative complications (3 cases within one month) after the femtosecond-laser assisted cataract surgery (FLACS). Ziemer Femto LDV Z8 was used for performing the capsulorrhexis and lens fragmentation in all surgeries.  All surgeries were performed by the same surgeon and passed uneventfully without intraoperative complications. The epiretinal membrane without macular traction or signs of macular oedema was diagnosed during OCT screening procedure before the surgery in all cases. Two patients out of three were diagnosed with pseidoexfoliative disease. All patients received Yellox (Bromfenac) 2 times a day for 3 days as a premedication before the surgery, and 10 days after the surgery. Ducressa (Dexamethasonum, Levofloxacinum) was prescribed 4 times a day for 10 days.  

There was a pesudophacic macular oedema diagnosed 2 weeks after the surgery during the follow-up examination. with a central thickess ranging from 521 to 645 microns. The treatment was initiated by prescribing the Carbonic anhydrase inhibitors and subtenon injections of Depo Medrol. The macular oedema didn't resolved during next 10-14 days. Intravitreal injection of Kenalog was prescribed, that helped to manage the macular oedema and to increase the visual acuity. 

The author informs that surgeries were performed during the lurning curve of FLACS .There were no single Irvine-Gass syndrome registred after similar surgeries performed by other surgeons.

The special care should be taken when performing the femtosecond-laser assisted cataract surgery on patients with macular pathology

The capsulorrhexis should be planned in a manner that there is a safe distance between the planned capsulorrhexis and the margin of the iris to prevent the iris irritation by the laser beam.