IntroductionThe introduction of phacoemulsification in the 1990smade combined cataract surgery and vitrectomy a prac-tical procedure. Small and secure corneal incisions, in-creased anterior chamber stability, and implantation ofthe intraocular lens (IOL) in a stable capsular bagimproved the safety and visual outcomes of phacovitrec-tomy [1]. Refinements in vitrectomy instrumentation andtechniques, including sutureless pars plana incisions,have further improved the outcomes of this combinedprocedure [2].Femtosecond lasers have been used successfully to per-form some steps in cataract surgery. These have beenreported to produce superior corneal incisions, more preciseand stronger capsulotomies, and require reduced phacoe-mulsification power [3, 4]. We retrospectively report eightcases that underwent femtosecond laser-assisted cataract ex-traction in combination with sutureless 25-gauge vitrectomy.Materials and methodsEight cases with co-existing retinal pathologies (Table 1)andcataract underwent combined femtosecond laser-assistedcataract extraction and sutureless 25-gauge vitreoretinal sur-gery. Informed written consent was obtained for all subjects.Surgical techniqueThe patients were initially placed in the operating suiteunder the femtosecond laser (LenSx Lasers Inc., AlisoViejo, CA). Under topical anesthesia (tetracaine 1 % Min-ims), a disposable patient interface was docked to thepatient’s eye. Once adequate suction was achieved, the lasertreatment was performed after selection of capsulotomy andlens fragmentation patterns. The capsulotomy diameterwassetfor5mm;withananteriorandposterioroffsetof 150 μmand300μm, respectively. For the lens, themethod of fragmentation was“chop” (Fig. 1, laser phaco-fragmentation immediately prior to removal of the cata-ract). Anterior and posterior offsets were set at 500 and1,100 μm.Following the laser ablation, a retrobulbar block (1 %ropivacaine + hyaluronidase 75 μg/ml) was used. Patientswere then transferred to the operating room. Three trans-conjunctival angled pars plana incisions were performedusing 25-gauge trocar microcannula (Alcon, Fort Worth,TX, USA) in the inferotemporal, superotemporal, andsuper-onasal quadrants 3.5 mm from the limbus. The inferotem-poral microcannula was connected to an infusion line,whereas the other two microcannulae were closed withplugs. The infusion line was kept off to prevent posteriorvitreous pressure during phacoemulsification and IOL im-plantation. Phacoemulsification was completed through aclear corneal superotemporal incision and was followed byinsertion of an AcrySof SN60WF foldable IOL (Alcon, FortWorth, TX, USA). A near-complete vitrectomy includingvitreous base shaving was performed (Accurus, Alcon Lab-oratories, Inc., Fort Worth, TX, USA). Where indicated, the