Penetrating femtosecond arcuate keratotomy presenting with corneal edema

We report a case of full-thickness penetration of an arcuate incision during femtosecond-assisted cataract surgery. A 78-year-old female underwent femto-cataract surgery with femto-arcuate incision. She presented with decreased vision and corneal edema 3 weeks later and was found to have full-thickness penetration of the arcuate incision with an internal wound gape. The patient was managed with closure of the internal wound gape using full-thickness corneal sutures. This resulted in a clear cornea with complete visual recovery. Careful depth setting via optical coherence tomography at the time of femto-cataract surgery is vital for minimizing the risk of this complication.