The aim of this study was to observe the safety and effectiveness of femtosecond laser-assisted with phacoemulsification surgery of cataracts combined with tension ring and intraocular lens implantation in the treatment of subluxated lens (SLs).

22 cases of 26 eyes with SL were enrolled in Guangzhou Aier Eye Hospital from October 2017 to March 2019, including 18 male (21 eyes), 5 female (5 eyes); the age range from 5-65, average age (45.8±18.2). Among of them, 14 cases of 14 eyes with traumatic lens subluxation, 5 cases of 9 eyes with Mafan syndromes, and 3 spontaneous cases of 3 eyes with unexplained reasons. According to the extent of zonular weakness, 11 eyes of them were mild; 7 eyes of them were medium, and 8 eyes of them were severe. The femtosecond laser-assisted with phacoemulsification surgery of cataracts combined with tension ring and intraocular lens implantation was used to perform, and intraoperative and postoperative complications were evaluated. Visual acuity and intraocular pressure after operation were recorded. The stability of capsular bag and intraocular len were assessed. The best corrected visual acuity (BCVA) before and after surgery was described by the number and percentage of eyes. Wilcoxon testing was used to compare preoperative and postoperative visual acuity.

All the operations of 26 eyes were completed and SLs were implanted into capsular bag successfully. Intraoperative complications were mainly subconjunctival hemorrhage (20/26 eyes), incomplete capsulotomy (5/26 eyes) and contracted pupils (4/26 eyes). Postoperative complications such as macular edema, endophthalmitis and retinal detachment were not found. BCVA of 26 eyes after surgery was improved to some extent. Before the cataract surgery, the eyes with BCVA was ≥0.5, which had 2 patients; after cataract surgery, the eyes with BCVA was ≥0.5, which had 14 patients. Before cataract surgery, eyes with BCVA was between 0.3 and 0.5, which had 2 patients; after cataract surgery, eyes with BCVA was between 0.3 and 0.5, which had 8 patients. Compared with that before cataract surgery, the postoperative of BCVA was significantly improved (Z=-4.46, P<0.05). 24 SLs were stably centered; two intraocular lens were slightly displaced; and 3 eyes had anterior capsular contraction.

Femto second laser-assisted cataract surgery is an effective and safe approach for patients with SLs. This approach have shown the good clinical effect, including the increase in the successful rate of capsulorhexis, the decrease in the difficulty of phacoemulsification, and perioperative complications through preserving the stability of the capsular bag.