PMC6324126_01
Femtosecond laser-assisted cataract surgery in posttraumatic subluxated cataract: (a) femtosecond laser-assisted cataract surgery planning (arrows: vitreous in anterior chamber), (b) laser application (arrows: cavitation bubbles), (c) capsulotomy removed, (d) nylon hooks inserted (arrows: posterior limbal stab incisions), (e) limited anterior vitrectomy, (f) phacoemulsification, (g) I/A, (h) capsular tension ring inserted, (i) limited vitrectomy, and (j) postoperative well-centered intraocular lens
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A blob of vitreous in AC was observed in the OCT images, and the cavitation bubbles were enmeshed in the vitreous during femtosecond laser application [Fig. 1a and b]. Trypan blue was injected to stain the anterior capsule and the capsulotomy was removed with a microforceps in a circumferential manoeuver akin to capsulorhexis to release any residual adhesions [Fig. 1c]. The capsular bag was stabilized using five nylon hooks inserted through the previously created posterior limbal stab incisions [Fig. 1d]. Triamcinolone-assisted vitrectomy was performed to remove the vitreous present in the AC to prevent undue traction during surgery [Fig. 1e]. Low fluidics phacoemulsification was performed, and active fluidics helped to maintain a stable IOP (46 mmHg) during phacoemulsification [Fig. 1f]. A bimanual irrigation aspiration was performed to prevent undue stress on the zonules [Fig. 1g]. Capsular tension ring was implanted [Fig. 1h] followed by implantation of a single piece acrylic foldable IOL (Power + 21D) in the bag. Triamcinolone was injected to identify any remnant vitreous strands and vitrectomy was performed above the IOL plane to remove all vitreous and ensure a circular pupil [Fig. 1i and j].