title: Corneal perforation by an astigmatic keratotomy performed with an optical coherence tomography-guided femtosecond laser.
abstract: We present a case of corneal perforation secondary to an intrastromal astigmatic keratotomy performed with an optical coherence tomography-guided femtosecond laser. The keratotomy was concomitant with cataract surgery and resulted in a flat anterior chamber prior to the start of lens extraction. Interrupted nylon sutures were placed to seal the keratotomy prior to phacoemulsification. Escape of cavitation bubbles into the anterior chamber or the liquid interface can alert the surgeon to the possibility of unintended perforation of the endothelium or the epithelium, respectively.
  
  
  BACKGROUND
  Neither author has a financial or proprietary interest in any material or method mentioned.
authors: From the Massachusetts Eye and Ear Infirmary and the Boston Eye Group (Melki), Boston, Massachusetts, USA; the Royal College of Surgeons (Cherfan), Dublin, Ireland.
authors: Daniel G
authors: DG
authors: Cherfan
authors: From the Massachusetts Eye and Ear Infirmary and the Boston Eye Group (Melki), Boston, Massachusetts, USA; the Royal College of Surgeons (Cherfan), Dublin, Ireland. Electronic address: samir_melki@meei.harvard.edu.
authors: Samir A
authors: SA
authors: Melki
mesh_terms: D001251:Astigmatism / Q000601:surgery*; D063171:Corneal Pachymetry; D057112:Corneal Perforation / Q000209:etiology*; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006801:Humans; D007646:Keratotomy, Radial / Q000009:adverse effects*; D054018:Lasers, Excimer / Q000009:adverse effects*; D008875:Middle Aged; D018918:Phacoemulsification; D025321:Surgery, Computer-Assisted; D041623:Tomography, Optical Coherence