Femtosecond laser-assisted capsulotomy for treatment of bilateral anterior capsule contraction.

A 51-year-old woman developed severe fibrosis and occlusion of the visual axis in 1 eye, maintaining a pinhole aperture in the fellow eye, 2 months after uneventful cataract surgery and implantation of a hydrophilic trifocal intraocular lens in the capsular bag. She had not exhibited any risk factor for anterior capsule contraction preoperatively. Femtosecond laser-assisted capsulotomy with a fluid-filled interface system was used to perform a simultaneous anterior capsulotomy in both eyes. Preoperative calculations of the incision depth of the capsulotomy were performed using optical coherence tomography (OCT) and adjusted intraoperatively with the OCT system of the femtosecond laser. The energy level used in the first eye was increased for the second eye (4 μJ to 6 μJ) because of severe capsulotomy tags that had to be cut with scissors. Despite the increase in energy, a free-floating capsulotomy could not be achieved in the second eye.