Femtosecond laser-assisted cataract surgery without explantation of prepupillary iris-claw lens

Session Details

Session Title: Presented Poster Session: FLACS & Surgical Devices

Venue: Poster Village: Pod 1

First Author: : J.Martinez Toldos SPAIN

Co Author(s): :    J. Martínez-Toldos   A. Navarro-Navarro   C. Fernández-Martínez                 

Abstract Details

Purpose:

We present the case of a 61 year-old male with prepupillary iris-claw intraocular lens in both eyes (Artisan, Ophthec) and bilateral cataracts. Best corrected visual acuity was 20/50 and 20/40 in his right and left eye respectively. Sequential  femtosecond laser-assisted cataract surgery without explantation of the prepupillary IOL was planned.

Setting:

Department of Ophthalmology, Hospital General Universitario de Elche, Alicante, Spain.

Methods:

Intraocular lenses to be implanted in-the-bag were calculated considering the theoretical in-the-bag power on optical biometry, known power of Artisan IOLs and latest refraction. Femtosecond laser-assisted cataract surgery was planned. A 5.2mm anterior capsulotomy was set in both eyes, but final size was 4.9mm due to poor mydriasis (right eye). Anterior and posterior capsule were marked manually on OCT since the software had marked the Artisan IOL. Then, capsulotomy, nucleus fragmentation and corneal incisions were made. Main incision was placed at 90º to allow working under the Artisan IOL. Phacoemulsification and in-the-bag implantation of a hydrophobic lens were done.

Results:

On day 1 after surgery, uncorrected visual acuity was 20/22 and 20/20, with a +0.75 and +0.25 spherical equivalent in the right and left eye, respectively. Refraction and visual acuity remained stable one and three months after surgery, with normal anterior segment, intraocular pressure and fundus exam.

Conclusions:

Cases with cataract and phakic IOL usually undergo IOL extraction using a 5mm corneal incision before cataract extraction and in-the-bag lens implantation. We decided to maintain the iris-claw lens, therefore avoiding the required 5mm incision and its consequent astigmatism. The femtosecond laser-assisted cataract surgery was performed without complications, with good postoperative results. Uncorrected visual acuity was 20/22 and 20/20 in the right and left eye, respectively. As far as we know, this technique has not been described previously in the literature.

Financial Disclosure:

None