Alport Syndrome and Femtosecond Laser Assisted Cataract Surgery

Abstract

We report the surgical management of a patient with bilateral anterior lenticonus due to Alport syndrome using femtosecond laser-assisted cataract surgery (FLACS) and the Optiwave Refractive Analysis (ORA) system. A 38-year-old man with Alport syndrome presented to our department with visual loss due to anterior lenticonus in both eyes. Adjustments during bilateral FLACS were performed with the software’s calipers to manually delineate the anterior capsulotomy. Multifocal toric intraocular lenses (IOLs) were selected and placed in the posterior chamber with the aid of intraoperative aberrometry. The intended postoperative positioning parameters for the IOL as well as the planned visual acuity and refraction were achieved. The implementation of FLACS and intraoperative wavefront aberrometry is a safe and useful surgical approach for the management of cataract in challenging cases such as patients with anterior lenticonus due to Alport syndrome.

Femtosecond laser-assisted cataract surgery for complex cataracts – A review

“…Some authors have described FLACS for anterior lenticonus through separate case reports. [ 68 69 70 71 72 73 ] Using the LenSx ® system, Ecsedy et al [ 69 ] created a 4.8-mm anterior capsulotomy using a pulse energy of 5 µJ with 4 µm spot separation and 3 µm layer separation. On scanning electron microscopy, there was a uniform serrated profile created through the capsule.…”

Cataract: Advances in surgery and whether surgery remains the only treatment in future

“…Recent studies 42 , 43 , 44 on cataract patients with Fuchs endothelial corneal dystrophy indicated that FLACS may perform better than conventional phacoemulsification in the reduction of corneal endothelial cell loss and CCT changes. This trial of FLACS was expanded to more complex cases such as Marfan syndrome, subluxated lens, 45 , 46 Alport syndrome, 47 and shallow anterior chamber. 48 , 49 …”