Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung City, Taiwan.
BMC Ophthalmol. 2020 Jun 5;20(1):218. doi: 10.1186/s12886-020-01491-0.
Femtosecond laser-assisted cataract surgery (FLACS) has been reported to reduce phacoemulsification time and energy compared to the manual phacoemulsification technique. This technique has been used in several complex cases such as zonular weakness, subluxated lens and traumatic cataracts because it causes less damage to weakened zonules. However, corneal opacity is considered a relative contraindication to FLACS, as it may interfere with laser beam delivery, thus causing unpredictable capsulorhexis and lens fragmentation/liquefaction.
We present here a case with traumatic cataract and corneal opacity after laser-assisted in situ keratomileusis (LASIK). The patient was successfully treated using FLACS, capsular tension ring and intraocular lens (IOL) implantation. Posterior capsule rupture and vitreous loss were noted during the operation. However, the intraocular lens was successfully captured because of a complete capsulorhexis performed by FLACS.
This case report demonstrates that FLACS is a useful tool in selected patients with concurrent corneal opacity and traumatic cataract.
飞秒激光辅助白内障手术（FLACS）已被报道可减少超声乳化时间和能量，与手动超声乳化技术相比。由于该技术对薄弱的悬韧带造成的损伤较小，因此已用于治疗一些复杂病例，如悬韧带松弛、晶状体半脱位和外伤性白内障。然而，角膜混浊被认为是 FLACS 的相对禁忌症，因为它可能会干扰激光束传输，从而导致不可预测的囊膜切开和晶状体碎裂/液化。
我们在此介绍一例 LASIK 术后外伤性白内障伴角膜混浊的患者。该患者成功接受了 FLACS、囊膜张力环和人工晶状体（IOL）植入治疗。术中发现后囊破裂和玻璃体丢失。然而，由于 FLACS 完成了完整的囊膜切开，因此成功捕获了人工晶状体。
本病例报告表明，对于同时存在角膜混浊和外伤性白内障的特定患者，FLACS 是一种有用的工具。
