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Chen DZ, Chee SP. Femtosecond laser-assisted cataract surgery for complex cataracts - A review. Indian J Ophthalmol 2024; 72:629-636. [PMID: 38648431 PMCID: PMC11168539 DOI: 10.4103/ijo.ijo_2996_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 04/25/2024] Open
Abstract
Since its inception in 2009, femtosecond laser-assisted cataract surgery (FLACS) has become an alternative to conventional phacoemulsification cataract surgery (CPCS). Clinical studies were unable to demonstrate superior visual outcomes, but revealed reduced endothelial cell loss. More recently, the cost-effectiveness of FLACS over CPCS in routine cataract surgeries has been challenged. However, the unique abilities of FLACS to customize anterior capsulotomies precisely, soften and fragment the nucleus without capsular bag stress, and create corneal incisions may have special utility in complex cataract and less-common scenarios. In this article, we review the unique role of FLACS in complex cataract surgeries and how it could play a role to improve the safety and predictability of nonroutine cataract surgery.
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Affiliation(s)
- David Z Chen
- Department of Ophthalmology, National University Hospital, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Soon-Phaik Chee
- Department of Ophthalmology, National University Hospital, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ocular Inflammation and Immunology, Singapore National Eye Centre, Singapore
- Department of Cataract, Singapore Eye Research Institute, Singapore
- Department of Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
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Portney DS, Thibodeau AR, Mian SI. Recent Updates in Femtosecond Laser-assisted Cataract Surgery. Int Ophthalmol Clin 2021; 61:77-94. [PMID: 33337795 DOI: 10.1097/iio.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van der Westhuizen DP, Stuart KV. Bilateral spontaneous anterior lens capsule ruptures in a child: A rare presentation of Alport syndrome. Am J Ophthalmol Case Rep 2020; 20:100896. [PMID: 33015404 PMCID: PMC7522691 DOI: 10.1016/j.ajoc.2020.100896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/26/2020] [Accepted: 08/16/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose This report describes the rare case of a child with bilateral spontaneous anterior lens capsule ruptures as the presenting feature of Alport syndrome. Observations The clinical presentation, special investigations and surgical management of the child are described, accompanied by a brief discussion of the genetic basis for the ocular and systemic manifestations of Alport syndrome. Conclusions Bilateral spontaneous anterior lens capsule ruptures as the presenting feature of Alport syndrome has not been described before.
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Affiliation(s)
- Dian Petrus van der Westhuizen
- Corresponding author. Department of Ophthalmology, Kimberley Hospital Complex, Du Toitspan Road, Kimberley, 8301, Northern Cape, South Africa.
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Nath M, Gireesh P. Femtosecond laser-assisted cataract surgery in Alport's syndrome - A case report. Indian J Ophthalmol 2020; 67:1891-1893. [PMID: 31638065 PMCID: PMC6836590 DOI: 10.4103/ijo.ijo_586_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Alport's syndrome with anterior lenticonus poses significant challenges during capsulorhexis with high chances of peripheral extension. We report a case of 23-year-old lady with Alport's syndrome with anterior lenticonus in the left eye that underwent successful femtosecond laser-assisted cataract surgery (FLACS). The anterior lenticonus was eccentric nasally; hence, the FLACS capsulotomy was positioned slightly nasally so that the capsulotomy margin was outside the cone base. The distance vision improved from 6/24 to 6/6 at one-month follow-up. In summary, FLACS improved the safety of cataract surgery in an eye with anterior lenticonus and yielded excellent visual outcomes.
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Affiliation(s)
- Manas Nath
- Department of Cataract Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Prasanth Gireesh
- Department of Cataract Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
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Abstract
Anterior lenticonus is a characteristic ocular feature of Alport syndrome, leading to progressive vision deterioration. Surgical lens removal may be an option in such cases, and the role of femtosecond laser-assisted cataract surgery (FLACS) has been recently described. Herein, we report the third described case, to our knowledge, of bilateral anterior lenticonus surgically approached through FLACS. A 25-year-old man with X-linked Alport syndrome complained of bilateral progressive vision loss. Ophthalmological evaluation revealed a corrected distance visual acuity of 20/63 in both eyes and bilateral anterior lenticonus associated with anterior polar cataract. FLACS was performed, followed by IOL placement on the capsular bag, without any intraoperative complications. One month postoperatively, uncorrected distance visual acuity was 20/20 in both eyes. Considering these results and the information published so far, this technology might be a good option for these patients.
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Mimura T, Iida M, Noma H, Kamei Y, Kondo A, Yoshida M, Oguri M, Tanaka Y, Mizota A. Does Clear Corneal Cataract Surgery Influence Conjunctivochalasis? J Ophthalmic Vis Res 2020; 15:270-272. [PMID: 32308966 PMCID: PMC7151499 DOI: 10.18502/jovr.v15i2.6749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/04/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tatsuya Mimura
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Michiko Iida
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Hidetaka Noma
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Yuko Kamei
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Aki Kondo
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Maiko Yoshida
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Manami Oguri
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Yuka Tanaka
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
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Orts-Vila P, Amparo F, Rodríguez-Prats JL, Tañá-Rivero P. Alport Syndrome and Femtosecond Laser-assisted Cataract Surgery. J Ophthalmic Vis Res 2020; 15:264-269. [PMID: 32308965 PMCID: PMC7151501 DOI: 10.18502/jovr.v15i2.6748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 01/07/2020] [Indexed: 11/24/2022] Open
Abstract
We report the surgical management of a patient with bilateral anterior lenticonus due to Alport syndrome using femtosecond laser-assisted cataract surgery (FLACS) and the Optiwave Refractive Analysis (ORA) system. A 38-year-old man with Alport syndrome presented to our department with visual loss due to anterior lenticonus in both eyes. Adjustments during bilateral FLACS were performed with the software's calipers to manually delineate the anterior capsulotomy. Multifocal toric intraocular lenses (IOLs) were selected and placed in the posterior chamber with the aid of intraoperative aberrometry. The intended postoperative positioning parameters for the IOL as well as the planned visual acuity and refraction were achieved. The implementation of FLACS and intraoperative wavefront aberrometry is a safe and useful surgical approach for the management of cataract in challenging cases such as patients with anterior lenticonus due to Alport syndrome.
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Affiliation(s)
| | - Francisco Amparo
- Cornea Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Department of Clinical Sciences, Division of Health Sciences, University of Monterrey, Monterrey, Mexico
| | - José Luís Rodríguez-Prats
- Department of Cataract and Refractive Surgery, Clínica Vistahermosa, Oftalvist Alicante, Alicante, Spain
| | - Pedro Tañá-Rivero
- Department of Cataract and Refractive Surgery, Clínica Vistahermosa, Oftalvist Alicante, Alicante, Spain
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Barnes AC, Roth AS. Femtosecond laser-assisted cataract surgery in anterior lenticonus due to Alport syndrome. Am J Ophthalmol Case Rep 2017; 6:64-66. [PMID: 29260061 PMCID: PMC5722156 DOI: 10.1016/j.ajoc.2017.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/13/2017] [Indexed: 10/25/2022] Open
Abstract
Purpose We describe a case of bilateral anterior lenticonus in a patient with Alport syndrome treated with femtosecond laser-assisted cataract surgery (FLACS). Observations FLACS was performed without complication, and a desirable postoperative visual acuity was achieved. Conclusions and importance Femtosecond laser-assisted cataract surgery is an effective approach for managing patients with anterior lenticonus secondary to Alport syndrome.
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Affiliation(s)
- Alexander C Barnes
- Cleveland Clinic Cole Eye Institute, 9500 Euclid Avenue/i-13, Cleveland, OH 44195, United States
| | - Allen S Roth
- Cleveland Clinic Cole Eye Institute Beachwood, 2000 Auburn Drive, Suite 100, Beachwood, OH 44122, United States
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Gambrelle J, Sadaoui M, Thierry T, Le Loir M. [Clear lens extraction for the treatment of anterior lenticonus in Alport's syndrome]. J Fr Ophtalmol 2016; 39:e139-40. [PMID: 27131425 DOI: 10.1016/j.jfo.2015.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 05/29/2015] [Accepted: 06/11/2015] [Indexed: 11/27/2022]
Affiliation(s)
- J Gambrelle
- Ophtasiam, 5, bis rue Amiral-Linois, 29200 Brest, France; Clinique Pasteur, 83, rue Auguste-Kervern, 29200 Brest, France.
| | - M Sadaoui
- Service d'ophtalmologie, centre hospitalier Yves-Le-Foll, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France
| | - T Thierry
- Service d'ophtalmologie, centre hospitalier Yves-Le-Foll, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France
| | - M Le Loir
- Centre ophtalmologique genevois, 17, avenue Mendes-France, 74100 Annemasse, France
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