Femtosecond laser-assisted cataract surgery in complex cases.

PURPOSE: To describe the use of the femtosecond laser in complex cataract cases.

SETTING: Department of Ophthalmology, University of Colorado, Aurora, Colorado, USA.

DESIGN: Retrospective case series.

METHODS: This was a single-center retrospective review of consecutive complex cataract surgery cases in which the Lensx femtosecond laser was used between October 2012 and February 2015. Complex cases were defined as white cataracts, dense brunescent cataracts, or cataracts in which zonulopathy was identified preoperatively. Outcome measures included an assessment of the capsulotomy, surgical complications, and postoperative corrected distance visual acuity (CDVA).

RESULTS: Thirty-four eyes of 34 patients were included in this study; 27 had white cataract, 3 had dense brunescent cataract, and 6 had zonulopathy (2 of these also had white cataract). Three patients had an incomplete capsulotomy, and 3 had small radial tears in the anterior capsule. Four patients (11.7%) developed posterior capsule tears during phacoemulsification; 1 of these subsequently had pars plana vitrectomy for a retained lens fragment. Twenty-eight (97%) of 29 patients had a postoperative CDVA of 20/40 or better. Three patients were identified with comorbidities that limited postoperative CDVA. One patient developed postoperative cystoid macular edema.

CONCLUSION: The femtosecond laser was useful in the surgical approach to patients with complex cataracts, especially for the creation of the capsulotomy.

FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.