Femtosecond laser-assisted cataract surgery in eyes with foldable anterior or posterior chamber phakic intraocular lenses

We describe a technique for the application of femtosecond laser-assisted cataract surgery in eyes with cataract and previous implantation of a foldable anterior or posterior chamber phakic intraocular lens (pIOL). In 2 eyes with an anterior chamber pIOL (angle-supported Acrysof Cachet) and 3 eyes with a posterior chamber pIOL (2 eyes with an Implantable Collamer Lens pIOL; 1 eye with a Phakic Refractive Lens), a femtosecond laser was used to create a capsulotomy, perform lens fragmentation, and create corneal incisions with the pIOL in situ. In all cases, the capsulotomy was created successfully. Lens fragmentation was complete in 4 eyes and incomplete in 1 eye, where trapped cavitation bubbles in the space between the posterior chamber pIOL and anterior lens capsule were evident as a result of a shallow vault of the pIOL.