Karas Faris I, Arteaga Andrea, Cortina M Soledad
University of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, USA.
Am J Ophthalmol Case Rep. 2020 Jul 23;19:100837. doi: 10.1016/j.ajoc.2020.100837. eCollection 2020 Sep.
The purpose of this report is to describe the successful utilization of femtosecond laser assisted cataract surgery (FLACS) in a rare case of pyramidal anterior polar cataract in a female child.
The patient is a 6 years old girl that presented to the cornea clinic with a unilateral pyramidal cataract that was deemed to be visually significant, and therefore required cataract extraction and intraocular lens implantation surgery. FLACS was proposed and mother consented to proceed with the surgery. The femtosecond laser technology enabled precise completion of a central capsulotomy around the protruding pyramidal capsular lesion.
Various capsulorhexis techniques have been described and are used in pediatric cataracts including manual, can opener, vitrectorhexis, and laser, but none has become a standard. We propose the use of femtosecond laser for cataract extraction in cases of pediatric pyramidal cataracts, and hereby provide the first case report of such. The laser is a safe method for capsulorhexis construction and offers an additional advantage of intraoperative anterior segment OCT image guidance with visualization of the pyramidal lesion.
本报告旨在描述飞秒激光辅助白内障手术（FLACS）在一名女童罕见的锥形前极性白内障病例中的成功应用。
该患者为一名6岁女孩，因单侧锥形白内障就诊于角膜诊所，该白内障被认为具有明显视力影响，因此需要进行白内障摘除和人工晶状体植入手术。建议采用飞秒激光辅助白内障手术，其母亲同意进行该手术。飞秒激光技术能够精确地在突出的锥形囊膜病变周围完成中央囊切开术。
已有多种撕囊技术被描述并应用于儿童白内障手术，包括手法撕囊、开罐式撕囊、玻璃体切割撕囊和激光撕囊，但尚无一种成为标准方法。我们建议在儿童锥形白内障病例中使用飞秒激光进行白内障摘除，并在此提供首例相关病例报告。该激光是一种安全的撕囊构建方法，还具有术中眼前节光学相干断层扫描（OCT）图像引导并可视化锥形病变的额外优势。
