Combined Femtosecond Laser-Assisted Cataract Surgery and Small-Gauge Pars Plana Vitrectomy Using Different Devices: A New Trend for Vitreoretinal Surgery?

Abstract

Purpose : To report the efficacy, safety and benefits of femtosecond laser-assisted cataract surgery (FLACS) combined with sutureless 23-gauge pars plana vitrectomy (PPV).

Methods : This multicenter retrospective chart analysis and video evaluation was performed in 43 cases with co-existing retinal pathologies and cataracts treated with combined FLACS and sutureless 23-gauge vitreoretinal surgery. The inclusion criteria included concurrent treatment with FLACS and PPV and completion of follow-up visits at 1, 3, 6 months and 1 year. Complete records from ophthalmic examinations were available for all patients at these time points; the examinations included measurement of the best-corrected visual acuity and intraocular pressure, fundus examination, and OCT.
The exclusion criteria were a previous PPV or FLACS or FLACS and PPV performed during different surgeries. Patients also were excluded if information was missing from their medical records.
Patients were initially in the femtosecond laser operating suite where the LenSx Laser or Victus Femtosecond Laser were used. Once the docking procedure was achieved, laser treatment was performed after selection of corneal incision, capsulotomy and lens fragmentation patterns. After laser ablation, a retrobulbar block (1% ropivacaine and hyaluronidase 75 μg/ml) was used. Patients then were transferred to another operating room for the sutureless PPV procedure using a Constellation or Stellaris PC to perform it.

Results : In 44.2% and 55.8% of cases, respectively, the LenSx laser and the Constellation and the Victus and Stellaris PC were used. No complications developed during capsulorhexis even without a red fundus reflex, retrobulbar block or scleral indentation. Foldable intraocular lenses remained stable in the capsular bag during the vitreoretinal surgeries and postoperative visits. The mean times of femtosecond phacoemulsification, vitreoretinal surgery and total surgery were 22.9 ± 4.7, 43.1 ± 9.8, and 65.3 ± 8.6 minutes

Conclusions : The current study shows the feasibility of FLACS combined with small incision PPV providing a good safety profile and benefits to eyes submitted to combined surgery. It may be a future trend for combined surgery.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Improvement of BCVA and stability of CMT

 

Comparison between Lensx Femtosecond Laser and Constellation (LC Group) and Victus Femtosecond Laser and Stellaris PC (VS Group)