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case_images: View of the patient interface. The vacuum-level gauge is within normal limits (yellow arrow).
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case_images: The vacuum-level gauge was within normal limits (Figure 1), and an image obtained using built-in anterior segment optical coherence tomography showed no abnormality.
case_images: A small bubble is seen appearing at 3'o clock in view of the patient interface (yellow arrow), when laser irradiation began.
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case_images: Soon after the operator started firing the laser, it was found that a small bubble appeared at 3 o'clock and disappeared (Figure 2).
case_images: During lens fragmentation, the bubble is still observed (yellow arrow).
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case_images: In the second half of the lens fragmentation process, the small bubble reappeared in the same area immediately after laser beam emission started (Figure 3).
case_images: The bubble slowly becomes bigger. Wrinkles in the conjunctiva (yellow arrow) and a small eye tilt are also observed. The vacuum-level gauge is still within normal limits (blue arrow).
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case_images: During that time, wrinkles in the conjunctiva and a small tilt of the eye were also observed, while the vacuum-level gauge was still within normal limits (Figure 4).
case_images: Misplacement of the laser beam in the corneal layers immediately after the suction break. The device is still emitting the laser beam (yellow arrow).
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case_images: Finally, the PI lost adhesion to the sclera (ie, suction break occurred); however, due to the high repetition rate of the laser system, a fraction of a second after the suction break was sufficient for the laser beam to slip onto the corneal layers (Figure 5).
case_images: The automatic laser-emission-stop system is activated (yellow arrow).
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case_images: Although the operator kept the foot pedal pressed even after the PI was detached from the eye, an automatic laser emission-stop system was activated (Figure 6).
case_images: Intraoperative view of the grid-pattern laser beam trace in the corneal layers (yellow circle).
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case_images: During removal of the fragmented lens with the laser, a grid-pattern laser beam trace was observed between 2 o'clock and 4 o'clock, between the corneal apex and corneal limbus (Figure 7).
case_images: Postoperative slit-lamp image of the grid-pattern laser beam trace 1 year after surgery (yellow circle).
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case_images: However, the grid-pattern laser beam trace was still observed in the cornea (Figure 8).