Femtosecond Laser-Assisted Cataract Surgery in Glaucoma Patients, Case Series.

Abstract

BackgroundWe aim to describe the short-term effect of femtosecond laser-assisted cataract surgery (FLACS) in intraocular pressure (IOP), visual acuity (VA), number of hypotensive medications, and visual fields (VF) in glaucomatous eyes.MethodsSingle-center consecutive case series study included patients with a previous glaucoma diagnosis that needed cataract surgery alone or combined with incisional glaucoma procedure. IOP was measured during surgery immediately before and after pretreatment docking with an indentation tonometer. Changes in visual acuity (VA), IOP, number of medications, and VF were evaluated with a 90 day follow up.ResultsTwenty-seven eyes of 27 patients were included. Mean patient age was 70 years, 70% (n = 19) were female. Glaucoma diagnoses were: twelve patients with primary open-angle glaucoma, 13 with angle-closure glaucoma, and 2 with pseudoexfoliation glaucoma. Twenty-one patients underwent cataract surgery alone and 6 combined with an incisional glaucoma procedure (trabeculectomy or glaucoma drainage device implantation). We found no significant differences between pre-docking IOP (17.59 mmHg ± 6.25 SD) and post-docking IOP (17.23 mmHg ± 7.74 SD) p = 0.7. No surgical complications were recorded. The 90-day postoperative follow up revealed no changes from baseline regarding VF mean deviation, mean IOP, and the number of glaucoma medications decreased in both groups.ConclusionFLACS appears to perform well in the short-term in eyes with glaucoma undergoing cataract surgery alone or with an incisional glaucoma procedure. Comparable outcomes to manual phacoemulsification were obtained regarding IOP, VA, and postoperative period evolution.Clinical SignificanceSafety and efficacy of FLACS have not been properly studied in the glaucoma population, we present a case series with different glaucoma diagnoses who underwent FLACS alone or with an incisional glaucoma procedure.