EyeWorld Asia-Pacific June 2014 Issue

June 2014 8 EWAP FEAturE Femtosecond phaco techniques and outcomes by Vanessa Caceres EyeWorld Contributing Writer Seasoned surgeons share their first-hand experience and observations E veryone seems to love lasers—femtosecond lasers for cataract surgery, that is. “It’s been a wonderful, game-changing technology,” said William B. Trattler, MD , director of cornea, Center for Excellence in Eye Care, Miami, Fla., U.S. “We’re using the laser with more than 90% of our cataract patients, and it’s worked out well,” said Stephen G. Slade, MD , director, Laser Center of Houston, Houston, Texas, U.S. “Today’s cataract patient Status post laser capsulotomy and nuclear segmentation with softening performed with the Catalys laser system Source: Jonathan H. Talamo, MD Pattern of eight pie cuts with cylinders spaced 0.25 mm apart with the LENSAR laser, resulting in significant fragmentation of the nucleus Source: William B. Trattler, MD wants to see as well as possible with minimal use of glasses,” said Robert J. Weinstock, MD , the Eye Institute of West Florida, Largo, Fla., U.S. “To have this device that’s more precise is a tremendous advantage.” Still, for all the praise, there is a learning curve involved—and, like anything, it takes some time to get accustomed to new technology. EyeWorld interviewed physicians using various femto laser platforms for cataract surgery to find out how their technique differs with the laser compared with manual phaco and how their outcomes are different now. Here’s what they shared. Technique changes Using a femtosecond laser in cataract surgery patients does change the procedure—however, it’s not as drastic of a change as that faced by surgeons who may have at one time switched from extracapsular cataract extraction to phacoemulsification, said Dr. Weinstock, who uses the VICTUS laser (Bausch + Lomb, Rochester, NY, U.S.), the LenSx laser (Alcon, Fort Worth, Texas, U.S.), and the LENSAR Laser System (LENSAR, Orlando, Fla., U.S.). “I don’t think it’s something surgeons should be intimidated by. It’s very germane to what we’re already doing,” he said. “For the cataract surgeon who’s never made a femtosecond LASIK flap, there’s going to be a quick learning curve, but they are not very difficult lasers to operate and it’s not a challenging procedure in itself.” “The laser does the first half of AT A GLANCE • Femtosecond lasers have changed some surgeons’ approach to cataract surgery. • The use of the laser can make surgery easier, more predictable, and safer, surgeons say. • Areas that might present initial challenges include cortical cleanup, patient flow from the laser room to the OR, patient selection, and pupil dilation. • Patients are interested in laser-assisted cataract surgery, particularly if they are having refractive cataract surgery.