USING THE ANTERIOR CAPSULE DISC FOR CORNEAL ENDOTHELIUM PROTECTION DURING FEMTOSECOND LASER-ASSISTED CATARACT SURGERY

To present a surgical technique in which the anterior lens capsule is lifted and positioned against the corneal endothelium during femtosecond laser-assisted cataract surgery, providing additional protection in eyes with low endothelial cell counts.

A case presentation and literature review are provided.

An 82-year-old patient with Fuchs endothelial corneal dystrophy underwent corneal transplantation following cataract surgery in the right eye. To minimize endothelial cell loss during cataract surgery in the left eye, the anterior capsule disc was elevated and applied to the endothelium as a protective layer.  Additionally, surgical videos demonstrating this technique in cases of advanced (brunescent) cataract, along with a review of similar reports from the literature, will be presented.

Postoperatively, endothelial cell count was preserved, the cornea remained clear, and visual acuity was stable at 3 months of follow-up, with no indication for corneal transplantation at this stage.

In cases of low endothelial cell density or advanced cataract, utilizing the anterior lens capsule disc as an additional protective barrier may help preserve the corneal endothelium and improve surgical outcomes.