Case Reports

Femtosecond laser assisted cataract surgery for bilateral anterior lenticonus

Case Report Details

First Author: D.Hipolito-Fernandes PORTUGAL

Co Author(s):    M. Luís   D. Maleita   C. Xavier   S. Crisóstomo   V. Maduro   N. Alves     

Abstract Details

Purpose:

To report the third described case of a bilateral anterior lenticonus surgically approached through femtosecond laser assisted cataract surgery (FLACS).

Setting:

Ophthalmology Department, Centro Hospitalar Universitário de Lisboa Central

Report of Case:

A 25-year-old male with X-linked Alport Syndrome (AS) complained of bilateral progressive vision loss. At presentation he presented a best corrected visual acuity of 20/63 in both eyes. Slit-lamp evaluation revealed bilateral anterior lenticonus with bilateral anterior polar cataract and perimacular flecks were seen at fundoscopy. After discussing with the patient all possible refractive outcomes and approaches, FLACS (LensX© laser system and SoftFit™, Alcon Laboratories) was performed followed by monofocal intraocular lens (AcrySoft® IQ SN60WF, Alcon Laboratories) placement on the capsular bag. The procedures were performed without any intra-operative complications. One-month after surgeries, distance uncorrected visual acuity was 20/20 in both eyes with a residual refractive error of -0.125D in the right eye (OD) and +0.125D in the left eye (OS). Regarding IOL tilt, we found in OD a horizontal tilt of 4.3º and a vertical tilt of 3.2º and in OS a horizontal tilt of 2.1º and a vertical tilt of 2.7º.

Conclusion/Take Home Message:

Standard phacoemulsification is technically more difficult in AS patients due to capsule abnormalities (increased fragility/elasticity), increasing the risk of intra-operarative complications. On the other hand, FLACS may be easily and safely performed in anterior lenticonus patients, avoiding the thinnest conical part of the anterior capsule and allowing a well-centered capsulotomy. Considering our results and the information published so far, this technology seems to be a great option for these patients.

Financial Disclosure:

None