Corneal perforation following arcuate keratotomy in femtosecond laser assisted cataract surgery-a case series

PURPOSE: Identification and management of corneal perforation during arcuate keratotomy in femtosecond laser assisted cataract cases (FLACS). OBSERVATION: Low astigmatism correction in patients undergoing FLACS can be done by arcuate keratotomy incision made by femto-laser. Corneal perforation following arcuate keratotomy is commonly noted with manual incision but very few cases have been reported with femtolaser arcuate keratotomy (FSAK). In this case series, we have reported cases with corneal perforation following FSAK in patients undergoing FLACS. All the cases were managed by placing suture at the keratotomy site followed by phacoemulsification. CONCLUSION AND IMPORTANCE: Perforation can be expected in cases with FSAK though rare. Vigilant monitoring of the depth of laser passage and early detections of such perforations is required, for further prevention of complication. Astigmatic arcuate keratotomy is associated with a risk of perforation even if it is performed with femto laser, but risk of perforation is low and undoubtedly the benefit to risk ratio is high.