Incomplete femtosecond laser–assisted capsulotomy and lens... : Journal of Cataract & Refractive Surgery (original) (raw)

Case report

Incomplete femtosecond laser–assisted capsulotomy and lens fragmentation due to emulsified silicone oil in the anterior chamber

Grewal, Dilraj S. MD; Grewal, Satinder Pal Singh MD; Basti, Surendra MD*

From the Department of Ophthalmology (DS Grewal, SPS Grewal, Basti), Northwestern University Feinberg School of Medicine, Chicago, Illinois, and the Department of Ophthalmology (Grewal), Duke University, Durham, North Carolina, USA; the Grewal Eye Institute (SPS Grewal), Chandigarh, India

*Corresponding author: Surendra Basti, MD, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 440, Chicago, Illinois 60611, USA.

E-mail: [email protected]

Submitted June 15, 2014; revised July 23, 2014; accepted July 24, 2014.

Supported in part by unrestricted funds to the Department of Ophthalmology from Research to Prevent Blindness, New York, New York, and from the Heed Ophthalmic Foundation (Dr. D.S. Grewal), San Francisco, California, USA.

Figure:

No Caption available.

First author:

Dilraj S. Grewal, MD

Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

Abstract

We report 2 cases involving femtosecond laser–assisted cataract surgery following a retinal-detachment repair performed 1 and 2 years earlier using silicone oil endotamponade that was subsequently removed. Preoperative slitlamp examination did not show emulsified silicone oil in the anterior chamber. Intraoperatively, however, emulsified silicone oil was seen on anterior segment optical coherence tomography (AS-OCT) as a distinct hyperreflective retrocorneal line and there was no penetration of the OCT signal or delivery of the femtosecond laser treatment through this area, resulting in incomplete capsulotomy and lens fragmentation in both cases. Because silicone oil has a lower density than aqueous and migrates superiorly, careful preoperative gonioscopic examination to evaluate for emulsified silicone oil in the superior angle is warranted in eyes having femtosecond laser–assisted cataract surgery after a vitrectomy with silicone-oil endotamponade. Review of intraoperative OCT images can detect emulsified silicone oil, which would allow the procedure to be modified appropriately to prevent complications.

Financial Disclosure

No author has a financial or proprietary interest in any material or method mentioned.