Femtosecond cataract surgery can be performed in presence of vitreous fluid

Zonular dehiscence can be due to traumatic injury from external trauma or iatrogenic trauma from previous intraocular surgery, nontraumatic causes such as pseudoexfoliation, or congenital disorders such as Marfan syndrome. Regardless of the etiology, zonular dehiscence leads to lens instability within the eye.An unstable lens due to compromised zonules with a dense cataract poses challenges even to an experienced phaco surgeon. Such a combination increases the risk of further vitreous loss, iatrogenic corneal endothelial damage, secondary corneal edema and a dropped nucleus into the vitreous cavity, all of which can have a deleterious effect on the final visual outcome. Hence, a comprehensive pre-surgical examination, detailed surgical planning and a least traumatic surgical approach will be beneficial in dealing with such difficult cataract cases. Femtosecond laser-assisted cataract surgery helps in softening the dense cataract and performing laser capsulotomy with the least amount of lens movement and hence indirectly affords protection to the existing zonules and sustains the lens in its current resting position.