Use of Femtosecond Laser for Cataract Surgery in Patients With Previous Anterior Lamellar Keratoplasty and Corneal Scar: A Case Report

Abstract

This study describes the outcomes of femtosecond laser‐assisted cataract surgery (FLACS) in patients with prior corneal scarring and prior anterior lamellar keratoplasty (ALK). Two male patients, aged 65 and 61 years, presented for cataract surgery with a central corneal scar and previous ALK, respectively. Both underwent standard FLACS to address their cataracts amidst these complex corneal conditions. The procedure successfully achieved a centered 5.0 mm capsulotomy without tags or tears, and the lens was segmented into a sextant pattern and removed without difficulty. No serious intraoperative complications occurred. In the first case, best corrected visual acuity improved from 20/150 to 20/40 at 1‐month postoperation, with the patient reporting enhanced visual clarity. In the second case, visual acuity improved from 20/800 to 20/100 1 month after surgery, with further enhancement to 20/60 following scleral lens fitting. This study represents an existing technique on the use of FLACS in patients with ALK and corneal scarring. The findings demonstrate that FLACS can be effectively and safely performed in these challenging cases, providing valuable insights into its potential advantages over traditional manual cataract surgery, particularly in patients with compromised ocular structures and limited lens visibility.