Femtosecond laser-assisted cataract surgery in shallow anterior chamber cases
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ORIGINAL PAPER
Femtosecond laser-assisted cataract surgery in shallow anterior chamber cases Andre´s Ferna´ndez-Vega Cueto . Ignacio Rodrı´guez-Una Jose´ F. Alfonso
. Pedro P. Rodrı´guez-Calvo .
Received: 6 February 2020 / Accepted: 17 October 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To assess the effectiveness, safety and predictability of femtosecond laser-assisted cataract surgery (FLACS) in eyes with shallow anterior chamber (AC). Methods This is a prospective consecutive clinical study. All eyes presented an anterior chamber depth (ACD) B 2.1 mm and were submitted to FLACS with monofocal intraocular lens (mIOL) or trifocal intraocular lens (tIOL) implantation. Uncorrected distance visual acuity (VA) and corrected distance VA values were used to assess efficacy and safety of the surgery. Refraction, intraocular pressure (IOP), endothelial cell density (ECD) and ACD were evaluated before and 6 months post-surgery. Results Phacoemulsification was carried out successfully in all eyes, without intra- or postoperative complications. Efficacy and safety indexes were 0.96 and 1.26 for the mIOL group, and 0.87 and 1.01 for the tIOL group, respectively. The mean postoperative spherical equivalent was - 0.06 ± 0.28D and - 0.14 ± 0.38D for the mIOL and tIOL groups, respectively. The ECD varied from 2470 ± 483 to 2009 ± 538 cells/mm2 (p \ 0.05) and from
A. Ferna´ndez-Vega Cueto I. Rodrı´guez-Una (&) P. P. Rodrı´guez-Calvo J. F. Alfonso Ferna´ndez-Vega Ophthalmological Institute, University of Oviedo, Avda. Dres. Ferna´ndez-Vega, 34, 33012 Oviedo, Spain e-mail: [email protected]
2443 ± 319 to 2245 ± 628 cells/mm2 (p = 0.06) for the mIOL and tIOL groups, respectively. IOP significantly decreased (p \ 0.05) after the surgery from 14.34 to 12.85 mmHg for the mIOL group and from 14.37 to 11.91 mmHg for the tIOL group, with a general reduction of medical hypotensive treatment in both groups (85% of cases required B number of medications). ACD changed significantly (p \ 0.05) from 1.96 ± 0.15 mm to 3.75 ± 0.30 mm after the surgery in the mIOL group and from 1.94 ± 0.15 mm to 3.23 ± 0.21 mm for the tIOL group. Conclusion FLACS with implantation of either mIOL or tIOL may provide good efficacy, safety and predictability in eyes with shallow AC. Keywords Femtosecond laser-assisted cataract surgery Monofocal intraocular lens Shallow anterior chamber Trifocal intraocular lens
Introduction Cataract surgery in short eyes or with a shallow anterior chamber (AC) involves specific peculiarities. First of all, intraocular lens (IOL) power calculation formulas do not perform as well for short eyes as they tend to do for other eyes [1]. IOL power calculations in highly hypermetropic eyes can be inaccurate as small mistakes in axial length (AL) measurements can translate to disproportionately large postoperative
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refractive errors [2]. In addition, the procedure itself is technically more difficult in these cases due to the limited man
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