September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A NEW SURGICAL TECHNIQUE IN CONGENITAL CATARACT WITH FEMTOSECOND LASER
Author Affiliations & Notes
  • PAOLO BORDIN
    Ophthalmology, Hospital of legnago, Legnago, Verona, Italy
  • GABRIELE VIZZARI
    Ophthalmology, Hospital of legnago, Legnago, Verona, Italy
  • Footnotes
    Commercial Relationships   PAOLO BORDIN, None; GABRIELE VIZZARI, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 934. doi:
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    • Get Citation

      PAOLO BORDIN, GABRIELE VIZZARI; A NEW SURGICAL TECHNIQUE IN CONGENITAL CATARACT WITH FEMTOSECOND LASER. Invest. Ophthalmol. Vis. Sci. 2016;57(12):934.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The aim of this study is to describe a technique for performing cataract surgery with a femtosecond laser (FLACS) in infants with bilateral polar cataract, by using a viscoelastic substance to visualize the posterior capsule.

Methods : A 2-year-old male presented with bilateral polar cataract visualized on slitlamp examination. His best-corrected visual acuity (BCVA) was 20/200 in OD and 20/100 in OS. The keratometry (SRK-Tformula) is obtained with IOL Master and the axial length with Ultrasound biomicroscopy. He underwent bilateral FLACS (Victus,B&L) followed by implantation of a intraocular lens (IOL). Anterior capsulotomy of 5 mm is performed by the laser. The eye has been opened for lens aspiration without complications. A capsular tension ring is implanted in the bag using a cohesive viscoelastic substance to avoid the future phimosis. A hole is created in the posterior capsule using a 27G needle and filled a short-chains viscoelastic device through the gap in the vitreal chamber, between the posterior capsula and the hyaloid. A new docking of the laser is performed after the closure of the corneal wounds. The real time-integrated optical coherence tomography (OCT) also visualizes the posterior capsule pushed up by the viscoelastic, allowing a centered central posterior capsulotomy of 4.5 mm, followed by mechanical anterior vitrectomy. A IOL is implanted in the bag of both eyes.

Results : The child was followed up on day 1, day 5, at 2 weeks, 4 weeks and 8 weeks. At each follow-up visit, complete ocular examinations including orthoptic examination of both eyes were performed.The cornea was clear and the intraocular pressure(IOP) was 15mmHg in OU at every visit.At 4 weeks the BCVA was 20/30 in OU.Anterior and posterior capsulotomies were complete and uniform, without tears. The IOL was centered in the bag. No complications were encountered.

Conclusions : The technique has been performed in a infant with congenital cataract and it can enhance the quality of pediatric cataract surgery.The capsule is very elastic and tends to tear peripherally in manual anterior capsulotomy.This can induce to a complete loss of the capsule protection during surgery, with damage of the capsular scaffold for the IOL placement. Using the viscoelastic to push up the capsule allow a better visualization of the capsular surface,in order to standardize the laser capsulotomy procedure and to obtain a safe,precise and repetitive surgery.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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