Femtosecond Laser-Assisted Cataract Surgery in Phakic Intraocular Lens With Cataract

PURPOSE: To report two cases of cataract with phakic intraocular lens (PIOL) in situ that underwent femtosecond laser-assisted cataract surgery (FLACS) along with PIOL explantation. METHODS: Case reports. RESULTS: The first case had an implantable collamer lens (ICL) in situ. A well-centered, circular femtosecond laser capsulotomy was achieved. Incomplete nucleotomy was noted due to the entrapment of cavitation bubbles beneath the ICL. Postoperative visual acuity was 20/20. The second case had a rigid iris-claw PIOL in situ. Successful femtosecond laser-assisted capsulotomy and nuclear fragmentation were achieved. The PIOL was disenclavated temporally and displaced inferiorly followed by completion of phacoemulsification. The PIOL was explanted at the end of surgery by enlarging the temporal incision. Postoperative uncorrected visual acuity was 20/32. CONCLUSIONS: The femtosecond laser can be used to create a capsulotomy and nuclear fragmentation through both anterior and posterior chamber PIOLs.