Femtosecond Laser-Assisted Cataract Surgery in a Cataractous Eye With Implantable Collamer Lens In Situ

Li, Shaowei; Chen, Xu; Kang, Yanwei; Han, Ning

doi:10.3928/1081597x-20160217-03

Cited by 12 publications

(18 citation statements)

References 11 publications

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“…In the current study, the feasibility of using FLACS in patients who have previously received PIOL is demonstrated. The results are similar to previous case experiences [ 8 , 9 ]. In previous studies, cases with PIOL were thought to be more challenging than conventional cases needing manual adjustment [ 8 ], and incomplete fragmentation or microadhesions were not uncommon [ 8 , 9 ].…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, the capsulorhexis created by FLACS is more circular and optimally sized compared to conventional capsulorhexis [ 7 ]. To date, only two studies have evaluated the feasibility of FLACS in patients with normal corneal endothelial cell count who have received PIOL implantation [ 8 , 9 ]. Herein, we report results obtained using FLACS in two patients with a low corneal endothelial cell count who had previously received PIOL implantation.…”

Section: Introductionmentioning

confidence: 99%

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Femtosecond laser-assisted cataract surgery in patients with phakic intraocular lenses and low endothelial cell counts: a case report

Lee¹,

Chao²,

Sun³

et al. 2017

BMC Ophthalmol

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BackgroundPhakic intraocular lens (PIOL) implantation has been used to correct myopia and myopic astigmatism, although corneal decompensation can occur after implantation. Femtosecond laser-assisted cataract surgery (FLACS) has gained in popularity due to its lower postoperative astigmatism and endothelial loss. Herein, we report the use of FLACS in patients who previously received PIOL implantation and have a low corneal endothelial cell count.Case presentationTwo patients with a previous iris-claw PIOL implantation were enrolled. The preoperative corrected distance visual acuity (CDVA) and diopter sphere (DS) were 20/32 and −0.25 D in patient 1 and 20/32 and −3.00 D in patient 2. Specular microscope examination revealed an endothelial cell density (ECD) of 1532/mm2 in patient 1 and 1620/mm2 in patient 2. Capsulotomy was performed smoothly using a femtosecond laser. Postoperative CDVA improved in both eyes, with a difference of DS less than 1 D from the preoperative estimation. Specular microscope examination revealed a decreased endothelial cell density (ECD) in patient 2, but no signs of corneal decompensation were detected.ConclusionsThe influence of using PIOL on capsulotomies performed via FLACS, in combination with preoperative refraction calculation, is minimal. A mild decrease in ECD may occur, but there is a low probability of severe corneal decompensation, even in patients with a low endothelial cell count.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Femtosecond laser-assisted cataract surgery in patients with phakic intraocular lenses and low endothelial cell counts: a case report

Lee¹,

Chao²,

Sun³

et al. 2017

BMC Ophthalmol

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“…Previously published literature shows both FLACS being used to successfully complete a circular anterior capsulotomy in the presence of pIOLs, 7,8 and laser blockage by redundant gas accumulated beneath the PC pIOL, resulting in incomplete anterior capsulotomy. 9 Low levels of laser energy avoid excessive cavitation and gas bubble formation. 7 It is critically important to assure a complete capsulotomy before proceeding to phacoemulsification.…”

Section: Discussionmentioning

confidence: 99%

“…6 The literature is also sparse on FLACS in the presence of phakic intraocular lenses. [7][8][9] In 2 eyes implanted with the rigid iris-claw phakic lens and in 1 eye with the implantable collamer phakic lens (ICL), all laser steps were successfully completed. 8 Laser parameters were modified by increasing depth, vertical spot spacing, and anterior and posterior safety margins for the ICL case.…”

Section: Introductionmentioning

confidence: 99%

“…7 It is also known that cavitation gas bubbles entrapped under the phakic intraocular lens (IOL) following femtosecond laser application may result in anterior capsulotomy tags. 9 Cataract surgery in highly myopic eyes can be complicated by zonular instability, extreme deepening of the anterior chamber (known as "lens-iris diaphragm retropulsion syndrome"), higher risk of postoperative retinal detachment, difficulties in predicting correct IOL power, and lower visual potential. [10][11][12] Theoretically, some of these challenges may be avoided by using FLACS, which helps to create a perfectly round anterior capsulotomy and softens the lens nucleus.…”

Section: Introductionmentioning

confidence: 99%

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Femtosecond laser–assisted cataract surgery in vitrectomized eye with posterior chamber phakic intraocular lens

et al. 2017

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SummaryWe describe a case of femtosecond laser-assisted cataract surgery (FLACS) in an eye with multiple comorbidities, including retinal detachment surgery, high myopia, posterior chamber phakic intraocular lens (PC pIOL) and residual, emulsified, silicone oil located in the anterior chamber. FLACS was affected by the optical blockage, but the incomplete capsular tear was recoverable. The case suggests that silicone oil bubbles concentrated at the dome of the posterior corneal surface, along with the PC pIOL optic edges and scars after corneal astigmatic relaxing incisions can lead to incomplete anterior capsulotomy.

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Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation

et al. 2022

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Purpose To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. Methods We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. Results ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. Conclusion There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.

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Femtosecond Laser-Assisted Cataract Surgery in a Cataractous Eye With Implantable Collamer Lens In Situ

Abstract: Femtosecond laser-assisted cataract surgery can be done in an eye with previous ICL implantation, but may prove to be more challenging than routine cases without an ICL in situ.

Cited by 12 publications

References 11 publications

Femtosecond laser-assisted cataract surgery in patients with phakic intraocular lenses and low endothelial cell counts: a case report

Femtosecond laser-assisted cataract surgery in patients with phakic intraocular lenses and low endothelial cell counts: a case report

Femtosecond laser–assisted cataract surgery in vitrectomized eye with posterior chamber phakic intraocular lens

Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation

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