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The purpose of this review is to identify complications following femtosecond laser-assisted cataract surgery (FLACS.)
A retrospective case series was performed on patients referred to a cornea service at a tertiary care facility who had complications after FLACS. Complications were stratified into three categories: infectious, intraoperative or refractive.
Eight patients were identified with complications due to FLACS. Four of the seven patients experienced infectious complications, including a S. pneumoniae ulcer at the arcuate incision. Three patients experienced intraoperative complications including a patient with iris atrophy and pigment epithelial loss with visual glare. The second complication involved inadvertent laser focus on the posterior capsule rather than anterior, resulting in a dropped nucleus. A third case resulted in a wound leak. A refractive complication in a patient with against-the-rule astigmatism preoperatively resulted in a flipped axis with 4D of with-the-rule astigmatism due to femtosecond LRI over-correction.
Studies have indicated similar rates of intraoperative complications between FLACS and phacoemulsification. This review highlights that FLACS is not without complications and some are unique with intraoperative laser use. With increasing adoption of laser assisted cataract surgery, surgeons must be aware of potential complications.