Tackling posterior polar cataract with FLACS: a prospective study

Session Details

Session Title: Presented Poster Session: FLACS

Venue: Poster Village: Pod 1

First Author: : H.Rai UK

Co Author(s): :    V. Wagh                       

Abstract Details

Purpose:

Posterior polar cataract is a uncommon form of congenital cataract cataract but it presents a special challenge to the phaco surgeon because of its higher predisposition to posterior capsular dehiscence during surgery. Femtosecond lasers provide improvements in reproducibility, centration and safety in cataract surgery esp in challenging cases.

Setting:

St Thomas' Hospital, London and Khanna Eye Centre, Delhi, India

Methods:

The technique was performed in 25 eyes of 20 patients with posterior polar cataract. A hybrid pattern of three cylinders and three chops was used for nucleotomy and controlled by the surgeon using the live anterior segment OCT. Block by block emulsification of the pre-chopped nucleus was done from the center outward, with the remaining outer rings acting as a protective cushion. Because of its sharp demarcation, the last epinuclear layer can be easily stripped using a combination of the phaco probe and bimanual irrigation/aspiration. This approach eliminates the need for any type of hydro procedure in posterior polar cataracts.

Results:

Total of 30 eyes of 25 patients were included in the study, out of which only 2.05% had posterior capsular rupture. Mean age of patients in our study was 54.35 +_ 9.5yrs (range 45 - 73yrs). There were 14 male patients and 11 female patients. Mean axial length was 22.40mm. Mean preop visual acuity was 0.949 while first post-operative visual acuity was 0.5137, which was statistically significant (P < 0.0001) (paired t test).

Conclusions:

Intraoperative complications during posterior polar cataract surgery can be minimized by femtosecond laser-assisted cataract surgery. The technique of femtosecond laser-assisted cataract surgery with a hybrid pattern of cylinder and chop is safe and effective in managing cases of posterior polar cataract, specifically for higher grades of nuclear sclerosis. FLACS reduces posterior capsule rupture rates and enhances safety in posterior polar cataract emulsification.

Financial Disclosure:

None