I saw a patient recently who had femtosecond laser assisted cataract surgery a month prior by an unknown surgeon. The patient had a perfectly round capsulorhexis and the IOL was nicely centered, but she was seeking a second opinion because of a refractive surprise. She wanted a plano result but ended up myopic and because she has a multifocal IOL, this proved problematic.
Her fix is relatively easy since we can simply perform LASIK for this low degree of residual myopia and astigmatism and give her the desired plano refractive outcome. When I examined her at the slit lamp, I noted that her laser-made phaco incision was completely avascular and did not nick the limbal vessels. There was a 1 mm gap between her incision and the limbal vessels. This means weaker and slower healing. The femtosecond laser can be adjusted so that the incision is placed appropriately to nick the limbal vessels. And certainly when using traditional or diamond keratomes, the same principal applies.
Click below to review the critical keys to making phaco incisions:
