ESCRS - POCAT109 - To Report A Case Of The Femtosecond-Laser Assisted Cataract Surgery To The Patient With Previously Performed Laser Eye Surgery (Lasik) And Phakic Iol Implantation

To Report A Case Of The Femtosecond-Laser Assisted Cataract Surgery To The Patient With Previously Performed Laser Eye Surgery (Lasik) And Phakic Iol Implantation

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT109 | Type: Case Report | DOI: 10.82333/ftgs-bw50

Authors: Dr Maksim Solomatin* 1 , A/Prof. Igors Solomatins 1 , Dr Andrei Solomatin 1 , Dr Jana Gertnere 1

1The Dr Solomatin eye center,Riga,Latvia

Purpose

To report a case of femtosecond laser–assisted cataract surgery in a patient with a history of LASIK and phakic intraocular lens (IOL) implantation for high myopia.

Setting

The Dr Solomatin eye center, Riga, Latvia.

Report of case

A patient was referred to our clinic with complaints of progressive deterioration of visual acuity in both eyes. Twenty years earlier, the patient had undergone laser refractive surgery (LASIK) followed by phakic IOL implantation in both eyes for high myopia. The patient was also receiving topical treatment for glaucoma.

Preoperative Examination

Visual Acuity and Intraocular Pressure:

  • OD:
    BCVA 0.2 cc −1.75 D sph −1.50 D cyl × 70° = 0.4
    IOP: 19 mmHg

  • OS:
    BCVA 0.1 cc −3.25 D sph −1.00 D cyl × 90° = 0.4
    IOP: 22 mmHg

Glaucomatous optic nerve damage was confirmed by visual field testing and optical coherence tomography (OCT).

Slit-lamp examination revealed central anterior (precapsular) lens opacification in both eyes, possibly associated with long-standing phakic IOL implantation.

Intraocular lens power calculation was performed using the ESCRS IOL Calculator, taking into account the previous refractive surgery.
Surgical Procedure

Femtosecond laser–assisted cataract surgery was performed in the right eye.

Capsulorhexis and lens fragmentation were successfully performed through the phakic IOL. After corneal incisions were created, the phakic IOL was explanted. Phacoemulsification and implantation of the EDOF IOL were completed uneventfully.
Postoperative Outcomes

Visual Acuity and Intraocular Pressure:

OD: BCVA 0.3+1 cc +0.50 D sph +0.75 D cyl × 130° = 0.5–0.6 IOP: 16 mmHg 

Best-corrected visual acuity was limited by pre-existing glaucomatous optic nerve damage.

Conclusion/Take home message

Femtosecond laser–assisted cataract surgery is a safe and effective method in complex cases involving prior refractive surgery and phakic IOL implantation. This approach may reduce intraocular manipulation and enhance precision, potentially minimizing surgical risk in anatomically challenging eyes.