HYDROGEL INSERT MISMATCH - A RARE CAUSE OF FAILED FEMTOSECOND LASER Assisted CATARACT SURGERY

Abstract

Background: Femtosecond laser-assisted cataract surgery (FLACS) offers high level of precision and automates the three major steps of cataract surgery - corneal incisions, anterior capsulotomy and lens fragmentation. An ideal dock is required for optimal outcomes in FLACS. However dock failure can occur due to various factors. Here, we report a case of failed FLACS due to mismatch of hydrogel insert. Case description: FLACS with toric intraocular lens (IOL) implantation was planned in right eye for a 57 year old male who was diagnosed with immature cataract in that eye. Due to mismatch between the corneal curvature and the hydrogel insert, multiple attempts were required to achieve dock which resulted in folds on the hydrogel insert, causing incomplete anterior capsulotomy and nuclear fragmentation. During surgery, capsulorhexis and nuclear fragmentation was completed manually. Rest of the surgery was uneventful. Conclusion: The choice of hydrogel insert should depend on the corneal curvature. Appropriate usage of hydrogel insert based on the keratometry readings will result in enhanced outcomes.