Femtosecond Laser-Assisted Cataract Surgery in Management of Phacomorphic Glaucoma

Abstract

Surgical Technique Kinga Kránitz, MD; Ágnes Ildikó Takács, MD; Andrea Gyenes, MD; Tamás Filkorn, MD; Róbert Gergely, MD; Illés Kovács, MD, PhD; Zoltán Zsolt Nagy, MD, DSC To report the use of femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma. An 89-year-old patient developed acute phacomorphic glaucoma in her right eye with elevated intraocular pressure (62 mm Hg), shallow anterior chamber, and mature cataract. After conservative antiglaucoma therapy and Nd:YAG iridotomy, femtosecond laser-assisted cataract surgery was performed. A Malyugin ring was implanted for mechanical pupil dilatation and a 4.8-mm capsulorrhexis and lens fragmentation was performed using a femtosecond laser system (Alcon LenSx Inc., Aliso Viejo, CA) followed by in-the-bag intraocular lens implantation. Intact 4.8-mm capsulorrhexis and successful lens fragmentation could be performed using femtosecond laser. After cataract surgery, the patient’s visual acuity increased from hand motions to 0.4 (Snellen 4/10) and the intraocular pressure returned to normal range without antiglaucoma drop therapy. The results indicate that femtosecond laser can be successfully used in certain cases of phacomorphic glaucoma, even if mechanical pupil dilatation is needed. [J Refract Surg. 2013;29(9):645–648.] From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary. Dr. Nagy is a consultant for Alcon-LenSx Inc. The remaining authors have no financial or proprietary interest in the materials presented herein. AUTHOR CONTRIBUTIONS Study concept and design (IK, KK, ZZN); data collection (AG, RG, IK, KK, ZZN, ÁIT); analysis and interpretation of data (TF, RG, IK, KK); drafting of the manuscript (IK, ZZN); critical revision of the manuscript (AG, TF, IK, KK, ZZN, ÁIT); statistical expertise (IK); administrative, technical, or material support (AG, KK, ZZN, ÁIT); supervision (RG, KK, ZZN) Correspondence: Kinga Kránitz, MD, Department of Ophthalmology, Semmelweis University, Maria Str. 39., 1085 Budapest, Hungary. E-mail: kranitzkinga@gmail.com 10.3928/1081597X-20130611-02