FLACS for Intumescent Cataract

In this video, Dr. Durval Carvalho Jr. and colleagues present a case of an intumescent white cataract that underwent femtosecond laser-assisted cataract surgery. The intraoperative OCT image of the lens shows a collection of fluid between the nucleus and the anterior capsule, as well as a highly convex anterior capsule. During the creation of the capsulotomy, a sudden flush of white fluid is visible from the capsular bag into the anterior chamber. Injection of trypan blue reveals an incomplete capsulotomy and a tear in the anterior capsule extending to the periphery. The cataract was markedly soft, allowing the surgeon to carry a gentle dry aspiration technique with intermittent viscoelastic replenishment. With this careful and slow approach, the surgeon prevented the tear from extending around the equator through the posterior capsule and was able to safely remove all of the nucleus.

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