Femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma

To report the use of femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma.

An 89-year-old patient developed acute phacomorphic glaucoma in her right eye with elevated intraocular pressure (62 mm Hg), shallow anterior chamber, and mature cataract. After conservative antiglaucoma therapy and Nd:YAG iridotomy, femtosecond laser-assisted cataract surgery was performed. A Malyugin ring was implanted for mechanical pupil dilatation and a 4.8-mm capsulorrhexis and lens fragmentation was performed using a femtosecond laser system (Alcon LenSx Inc., Aliso Viejo, CA) followed by in-the-bag intraocular lens implantation.

Intact 4.8-mm capsulorrhexis and successful lens fragmentation could be performed using femtosecond laser. After cataract surgery, the patient's visual acuity increased from hand motions to 0.4 (Snellen 4/10) and the intraocular pressure returned to normal range without antiglaucoma drop therapy.

The results indicate that femtosecond laser can be successfully used in certain cases of phacomorphic glaucoma, even if mechanical pupil dilatation is needed.