title: Incomplete femtosecond laser-assisted capsulotomy and lens fragmentation due to emulsified silicone oil in the anterior chamber.
abstract: We report 2 cases involving femtosecond laser-assisted cataract surgery following a retinal-detachment repair performed 1 and 2 years earlier using silicone oil endotamponade that was subsequently removed. Preoperative slitlamp examination did not show emulsified silicone oil in the anterior chamber. Intraoperatively, however, emulsified silicone oil was seen on anterior segment optical coherence tomography (AS-OCT) as a distinct hyperreflective retrocorneal line and there was no penetration of the OCT signal or delivery of the femtosecond laser treatment through this area, resulting in incomplete capsulotomy and lens fragmentation in both cases. Because silicone oil has a lower density than aqueous and migrates superiorly, careful preoperative gonioscopic examination to evaluate for emulsified silicone oil in the superior angle is warranted in eyes having femtosecond laser-assisted cataract surgery after a vitrectomy with silicone-oil endotamponade. Review of intraoperative OCT images can detect emulsified silicone oil, which would allow the procedure to be modified appropriately to prevent complications.
authors.affiliation: From the Department of Ophthalmology (DS Grewal, SPS Grewal, Basti), Northwestern University Feinberg School of Medicine, Chicago, Illinois, and the Department of Ophthalmology (Grewal), Duke University, Durham, North Carolina, USA; the Grewal Eye Institute (SPS Grewal), Chandigarh, India.
authors.forename: Dilraj S
authors.initials: DS
authors.lastname: Grewal
authors.affiliation: From the Department of Ophthalmology (DS Grewal, SPS Grewal, Basti), Northwestern University Feinberg School of Medicine, Chicago, Illinois, and the Department of Ophthalmology (Grewal), Duke University, Durham, North Carolina, USA; the Grewal Eye Institute (SPS Grewal), Chandigarh, India.
authors.forename: Satinder Pal
authors.initials: SP
authors.lastname: Singh Grewal
authors.affiliation: From the Department of Ophthalmology (DS Grewal, SPS Grewal, Basti), Northwestern University Feinberg School of Medicine, Chicago, Illinois, and the Department of Ophthalmology (Grewal), Duke University, Durham, North Carolina, USA; the Grewal Eye Institute (SPS Grewal), Chandigarh, India. Electronic address: sbasti@northwestern.edu.
authors.forename: Surendra
authors.initials: S
authors.lastname: Basti
mesh_terms: D000368:Aged; D057866:Anterior Capsule of the Lens / Q000473:pathology*; D000867:Anterior Chamber / Q000187:drug effects*; D002387:Cataract Extraction; D004655:Emulsions / Q000009:adverse effects*; D058450:Endotamponade; D006801:Humans; D007431:Intraoperative Complications; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000601:surgery; D012827:Silicone Oils / Q000009:adverse effects*; D041623:Tomography, Optical Coherence
chemical_list: D004655:Emulsions; D012827:Silicone Oils