Therapeutic Laser–Assisted Cataract Surgery in Complex Cataract Cases
To evaluate the safety and outcomes of femtosecond laser assisted surgery in complex cataract cases.
Retrospective chart review of eyes undergoing femtosecond laser assisted cataract surgery for complex cataracts between 2012 and 2014 at the University of Colorado Eye Institute, Aurora, CO. Eyes with dense white cataracts, soft white cataracts and phacodonesis were included in this study. The main outcomes measured include complications with anterior capsulorrhexis, other complications with surgery, pre- and post- operative best corrected visual acuity (BCVA).
Twenty-four eyes were included with an average age of 58 (range 27-83). Eleven eyes had dense white cataracts, 9 had soft white cataracts, while 5 had phacodonesis. One patient had phacomorphic glaucoma and another had an anterior capsular scar. Twenty eyes had pre-operative BCVA of count fingers or worse. Complete capsulorrhexis was performed by the laser in 22 cases. Two had small anterior tears that did not extend during phacoemulsification. Four patients had posterior capsule tears during surgery and two of these had lens fragmentation by the laser. Seventy-nine percent of patients achieved a BCVA of 20/40 or better.
The femtosecond laser is an effective tool for creating the anterior capsulotomy in complex cataract cases, especially in lenses that demonstrate phacodonesis. The safety and utility of lens fragmentation using the femtosecond laser in complex cases with dense nuclei is yet to be determined.