Background:Femtosecond laser astigmatic keratotomy(FSAK)and toric intraocular lens(IOL)implantation have been studied individually for comparison to treat astigmatism at cataract surgery.We report a case of surgically...Background:Femtosecond laser astigmatic keratotomy(FSAK)and toric intraocular lens(IOL)implantation have been studied individually for comparison to treat astigmatism at cataract surgery.We report a case of surgically induced high corneal astigmatism by laser thermal keratoplasty(LTK)in a patient with cataract who was successfully treated with simultaneous combination of FSAK and toric IOL implantation with femtosecond laser-assisted cataract surgery(FLACS).This is the first report of both procedures combined simultaneously,with or without history of LTK.Case Description:A 68-year-old male presented with a history of LTK with two enhancements each eye in 2004,with subsequent surgically induced high corneal astigmatism,and with age-related nuclear cataract of both eyes.IOL master demonstrated+7.71 diopters of astigmatism at 163 degree right eye and+3.29 diopters of astigmatism at 4 degree left eye.After extensive discussion of the risks and benefits,the patient agreed to undergo FLACS with FSAK with two 61 degrees of relaxation incisions(RIs)and toric IOL(Alcon SN6AT9)right eye;FLACS with toric IOL(Alcon SN6AT7)alone left eye.At 2-year follow-up,uncorrected visual acuity was 20/30 right eye,20/25 left eye.His best corrected visual acuity was 20/25(+0.25+1.00 axis 21)right eye and 20/20(plano+0.25 axis 90)left eye;his best corrected near visual acuity was J1+with add+2.50 diopters right eye and left eye.Conclusions:Patients with age-related cataract and LTK induced high corneal astigmatism can hardly be sufficiently treated with FSAK or toric IOL alone at the time of cataract surgery.An effective way is to combine large FSAK and toric IOL of the highest cylindrical power of T9,in our case,simultaneously,which can achieve an excellent long term visual outcome.展开更多
Purpose: The purpose of this study was to evaluate a new procedure aimed at lengthening the palpebral fissure to facilitate femtosecond laser-assisted cataract surgery in patients with small eyes. Method: A quick proc...Purpose: The purpose of this study was to evaluate a new procedure aimed at lengthening the palpebral fissure to facilitate femtosecond laser-assisted cataract surgery in patients with small eyes. Method: A quick procedure using the CO2 laser was adapted for patients with small eyes undergoing laser-assisted cataract surgery using the Catalys system. The UniPulse CO2 laser (Nidek) was used for laser lateral canthotomy on patients with small palpebral fissures to allow fitting of the Liquid OpticTM Interface eyepiece. Results: Lateral canthotomies were performed on 19 women and 7 men (ages ranged from 45 to 93 years) with lower eyelid lengths equal to or shorter than 32 mm who then underwent femtosecond laser-assisted cataract surgery. A total of 33 eyelids received laser lateral canthotomy with the CO2 laser;only one eyelid had lateral canthotomy with cold-steel tenotomy scissors. Dockings were completed for all 34 eyes with eyelids receiving lateral canthotomies. The 33 eyes with eyelids that received laser canthotomy with the CO2 laser had successful femtosecond laser-assisted cataract surgery. The one eye with the eyelid that received cold-steel canthotomy could not have femtosecond laser-assisted cataract surgery despite successful docking because of pupillary constriction. The findings were statistically significant;Fisher Exact Test showed a p-value of 0.0294. Conclusion: Laser lateral canthotomy with CO2 laser is a safe and effective method to allow docking and completion of femtosecond laser-assisted cataract surgery.展开更多
文摘Background:Femtosecond laser astigmatic keratotomy(FSAK)and toric intraocular lens(IOL)implantation have been studied individually for comparison to treat astigmatism at cataract surgery.We report a case of surgically induced high corneal astigmatism by laser thermal keratoplasty(LTK)in a patient with cataract who was successfully treated with simultaneous combination of FSAK and toric IOL implantation with femtosecond laser-assisted cataract surgery(FLACS).This is the first report of both procedures combined simultaneously,with or without history of LTK.Case Description:A 68-year-old male presented with a history of LTK with two enhancements each eye in 2004,with subsequent surgically induced high corneal astigmatism,and with age-related nuclear cataract of both eyes.IOL master demonstrated+7.71 diopters of astigmatism at 163 degree right eye and+3.29 diopters of astigmatism at 4 degree left eye.After extensive discussion of the risks and benefits,the patient agreed to undergo FLACS with FSAK with two 61 degrees of relaxation incisions(RIs)and toric IOL(Alcon SN6AT9)right eye;FLACS with toric IOL(Alcon SN6AT7)alone left eye.At 2-year follow-up,uncorrected visual acuity was 20/30 right eye,20/25 left eye.His best corrected visual acuity was 20/25(+0.25+1.00 axis 21)right eye and 20/20(plano+0.25 axis 90)left eye;his best corrected near visual acuity was J1+with add+2.50 diopters right eye and left eye.Conclusions:Patients with age-related cataract and LTK induced high corneal astigmatism can hardly be sufficiently treated with FSAK or toric IOL alone at the time of cataract surgery.An effective way is to combine large FSAK and toric IOL of the highest cylindrical power of T9,in our case,simultaneously,which can achieve an excellent long term visual outcome.
文摘Purpose: The purpose of this study was to evaluate a new procedure aimed at lengthening the palpebral fissure to facilitate femtosecond laser-assisted cataract surgery in patients with small eyes. Method: A quick procedure using the CO2 laser was adapted for patients with small eyes undergoing laser-assisted cataract surgery using the Catalys system. The UniPulse CO2 laser (Nidek) was used for laser lateral canthotomy on patients with small palpebral fissures to allow fitting of the Liquid OpticTM Interface eyepiece. Results: Lateral canthotomies were performed on 19 women and 7 men (ages ranged from 45 to 93 years) with lower eyelid lengths equal to or shorter than 32 mm who then underwent femtosecond laser-assisted cataract surgery. A total of 33 eyelids received laser lateral canthotomy with the CO2 laser;only one eyelid had lateral canthotomy with cold-steel tenotomy scissors. Dockings were completed for all 34 eyes with eyelids receiving lateral canthotomies. The 33 eyes with eyelids that received laser canthotomy with the CO2 laser had successful femtosecond laser-assisted cataract surgery. The one eye with the eyelid that received cold-steel canthotomy could not have femtosecond laser-assisted cataract surgery despite successful docking because of pupillary constriction. The findings were statistically significant;Fisher Exact Test showed a p-value of 0.0294. Conclusion: Laser lateral canthotomy with CO2 laser is a safe and effective method to allow docking and completion of femtosecond laser-assisted cataract surgery.