Femtosecond Laser-Assisted Cataract Surgery in Pediatric Marfan Syndrome

Abstract

The use of a femtosecond laser has potential to perform a circular, well-centered capsulotomy for subsequent capsular tension ring and intraocular lens implantation without decentration in patients with Marfan syndrome.

Femtosecond laser–assisted cataract surgery—current status and future directions

“…The pulse energy was maximized to 10 μJ and the incision depth increased to 1000 microns. 151 Lens fragmentation was performed using the sextant pattern. No lens softening was performed and the subluxated lens was stable during FLACS docking and laser delivery.…”

“…No lens softening was performed and the subluxated lens was stable during FLACS docking and laser delivery. 151 …”

Categorization and Surgical Techniques of Weak Zonule Based on Findings at Capsulorhexis during Cataract Surgery

“…A new generation of femtosecond laser for cataract surgery was introduced into ophthalmology in 2009 [24]. Since its introduction, femtosecond laser-assisted cataract surgery is increasing and offering advantages in complex cataracts such as traumatic cataracts, Marfan syndrome [25][26][27], and less severe cases of subluxated cataracts [13]. However, not every subluxated crystalline lens is applicable to this type of surgery; grossly subluxated lenses, poorly dilating pupils, and mobile crystalline lens represent contraindication to successful femtosecond laser-assisted cataract surgery [13].…”

Femtosecond laser will not be a standard method for cataract extraction ten years from now

“…3,10 It is also plausible that FLACS could improve success rates for patients with zonular instability (such as in pseudoexfoliation, traumatic cataracts, or Marfan syndrome), by facilitating the creation of a capsulotomy in a situation where it would otherwise be difficult. 12,23,27,34 Unfortunately, many of these patients also have poor pupillary dilation, and this will further limit the number who might benefit from FLACS. The problem for this small group of patients (and their surgeons) is that the market for costly femtosecond laser technology has to be large in order to continue to be financially viable for the industry and widely adopted by cataract surgeons.…”