We describe a technique for performing cataract surgery with a femtosecond laser in infants. Anterior capsulotomy and lens division are performed by the laser. A fluid-filled interface makes it possible to re-dock the laser to the eye for posterior capsulotomy after the eye has been opened for lens aspiration without complications. The integrated 3-dimensional optical coherence tomography also visualizes the posterior capsule, allowing a centered central posterior capsulotomy followed by mechanical anterior vitrectomy. The anterior and the posterior capsule disks are removed without capsule tears. The technique has been performed in 4 infants (ages 2, 4, 7, and 9 months) with congenital cataract. It can enhance the quality of pediatric cataract surgery.
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