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Efficacy of femtosecond laser-assisted cataract surgery in keratoconus patients with cataracts

Poster Details

First Author: K.Yamazaki JAPAN

Co Author(s):    R. Kimoto   Y. Shibata   J. Yoneyama   M. Inagaki   T. Hayashi   T. Mimura     

Abstract Details


The aim of this study is to determine the efficacy of femtosecond laser-assisted cataract surgery (FLACS) for cases of keratoconus.


Omiya Nanasato Eye Institute


FLACS was performed in 7 eyes of 4 patients (4 males, 2 females) with both cataract and keratoconus. Surgeries were performed between October 2013 and March 2018. Average age was 42.8 yrs. The K value of the anterior cornea ranged from 50.9 to 62.4D, and astigmatism ranged from 0.5 to 3.9D, respectively. Corneal thickness at the thinnest point was 362-584 μm. Three of the cases had cataracts due to atopic dermatitis. None of the patients had a history of acute hydrops. Two cases were intumescent white cataracts. FLACS was used to perform corneal incisions, lens fragmentation, and capsulotomy.


None of the eyes suffered suction breaks. Five out of 7 eyes received successful free-floating capsulotomies. The 2 cases with incomplete capsulotomies were both atopic dermatitis cases, of which one had an intumescent white cataract. One of these had severe atopic cataract with anterior subcapsular fibrosis. In 3 eyes, the primary corneal incision did not self-seal, and sutures were required. In the eye with the thinnest corneal pachymetry, both the primary and secondary corneal incisions did not self-seal, and sutures were required.


Keratoconic eyes with steep corneal curves and strong astigmatism were successfully treated by FLACS. Normal docking using the LenSx Softfit patient interface was achieved without complications. FLACS for keratoconus is safe and effective; however, corneal incisions may not self-seal even with a clean cut.

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