Femtosecond laser-assisted cataract surgery in patients with zonular weakness

PURPOSE: To present the clinical value of femtosecond laser assisted cataract surgery (FLACS) in eyes with compromised zonules. OBSERVATIONS: We present two cases of femtosecond laser assisted cataract surgery (FLACS) in eyes with compromised zonules. Three eyes from two patients with zonular weakness and cataract underwent FLACS (Alcon LenSx Lasers Inc., Aliso Viejo, CA). One patient underwent bilateral FLACS in the setting of spherophakia with zonular weakness. The other patient had Marfan's syndrome with associated ectopia lentis. Laser assisted capsulotomy was achieved in all eyes. One eye had vitreous prolapse during surgery and required an iris-sutured lens. All eyes had a postoperative corrected distance visual acuity of 20/25 or better. CONCLUSIONS AND IMPORTANCE: FLACS is a safe and effective alternative to conventional phacoemulsification cataract surgery in patients with zonular weakness.