Kodavoor Shreesha Kumar, V Preethi, Dandapani Ramamurthy, Ramamurthy Chitra
The Eye Foundation, Department of Cornea and Phacorefractive, Diwan Bahadur road, RS Puram, West Coimbatore, Tamil Nadu, 641002, India.
Fellow in Cornea and Phacorefractive, Department of Cornea and Phacorefractive, The Eye Foundation, Coimbatore, Tamil Nadu, India.
Am J Ophthalmol Case Rep. 2022 Feb 22;26:101432. doi: 10.1016/j.ajoc.2022.101432. eCollection 2022 Jun.
Identification and management of corneal perforation during arcuate keratotomy in femtosecond laser assisted cataract cases (FLACS).
Low astigmatism correction in patients undergoing FLACS can be done by arcuate keratotomy incision made by femto-laser. Corneal perforation following arcuate keratotomy is commonly noted with manual incision but very few cases have been reported with femtolaser arcuate keratotomy (FSAK). In this case series, we have reported cases with corneal perforation following FSAK in patients undergoing FLACS. All the cases were managed by placing suture at the keratotomy site followed by phacoemulsification.
Perforation can be expected in cases with FSAK though rare. Vigilant monitoring of the depth of laser passage and early detections of such perforations is required, for further prevention of complication. Astigmatic arcuate keratotomy is associated with a risk of perforation even if it is performed with femto laser, but risk of perforation is low and undoubtedly the benefit to risk ratio is high.
识别和处理飞秒激光辅助白内障手术（FLACS）中弧形角膜切开术期间的角膜穿孔情况。
接受FLACS的患者中，低散光矫正可通过飞秒激光制作的弧形角膜切开切口来完成。弧形角膜切开术后的角膜穿孔在手动切口时较为常见，但飞秒激光弧形角膜切开术（FSAK）导致的此类病例报告很少。在本病例系列中，我们报告了接受FLACS的患者在FSAK后发生角膜穿孔的病例。所有病例均通过在角膜切开部位放置缝线，随后进行超声乳化术来处理。
FSAK病例中虽罕见，但仍可能发生穿孔。需要密切监测激光通道深度并尽早发现此类穿孔，以进一步预防并发症。散光性弧形角膜切开术即使使用飞秒激光进行也存在穿孔风险，但穿孔风险较低，且无疑效益风险比很高。
