Efficacy of Femtosecond Laser-Assisted Cataract Surgery for Cataracts due to Atopic Dermatitis

Abstract

We retrospectively evaluated the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) for cataracts due to atopic dermatitis, which are often complicated by intumescent white cataract (IWC) and subcapsular fibrosis. Thirty-seven eyes of 30 cataract patients diagnosed with atopic dermatitis were included in the study. Nine eyes had IWC, and 13 eyes had anterior subcapsular fibrosis characteristic of atopic cataracts. Free-floating capsulotomy was achieved in 32 eyes (86%). Three eyes with fibrosis extending across the line of capsulotomy required manual excision. Incomplete capsulotomies due to anterior capsular tags were present in 4 eyes in the IWC group, which was significantly higher compared to non-IWC cases (<i>p</i> < 0.05). Radial anterior capsular tear, vitreous loss, and intraocular lens dislocation did not occur in any of the cases. FLACS can be performed safely in atopic cataract despite the presence of anterior subcapsular fibrosis and/or IWC.

Recent developments in anterior capsulotomy for cataract surgery

“…A case study of 30 eyes found that FLACS was an effective method for avoiding radial anterior capsular tear, vitreous loss, and IOL dislocation in cataracts caused by atopic dermatitis, including intumescent white cataracts and eyes with anterior subcapsular fibrosis. The study noted that incomplete capsulotomies occurred at a significantly higher rate for intumescent cataracts where leakage of lens material was observed [36]. Similarly, in a study of 58 white cataracts treated with FLACS, Chee et al [37] found that no incidences of Argentinian flag sign occurred but that incomplete capsulotomies were significantly associated with increased lens thickness and Morganian cataracts.…”

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

“…Yamazaki et al. 41 found that patients with atopic cataract can also get FLACS safely despite anterior subcapsular fibrosis and/or intumescent white cataract (IWC). 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.…”