Femtosecond laser assists in complex cataract surgery case

Cataract surgery is usually safe and relatively easy to perform, especially for the experienced eye surgeon. However, the degree of surgical difficulty when performing phacoemulsification often parallels the degree of cataract density that the surgeon faces.Phacoemulsification can be challenging when dealing with a very hard, brunescent cataract with a decreased protective epinuclear-cortex between the hard nucleus and the fragile capsule. If the lens is relatively unstable with compromised zonules, it further adds to the surgical difficulty. The potential collateral damage in these more difficult phacoemulsification cases can affect the iris, cornea and/or corneal endothelium, which may compromise the postoperative results and result in an unhappy patient who may require further surgery such as endothelial keratoplasty, if the corneal endothelium fails to recover from the extended surgical trauma. The combination of a fragile capsule and a brunescent cataract with a paucity of protective cortex can potentially contribute to capsular-lenticular block during hydrodissection or even a dropped nucleus. Surgeons have continued to improve and modify their surgical technique to help carry out a safe phaco procedure in these difficult cases that may be considered more stressful.