EyeWorld India June 2013 Issue

June 2013 16 EWAP FEAturE Table 1. Key system figures for the femtosecond lasers for cataract refractive surgery Source: Adapted and updated from Jonathan Talamo, MD Update on the femtosecond laser for cataract surgery With more surgeons using the devices, quantifying the benefits may become easier F emtosecond laser technology is a relatively new entity, first introduced for corneal surgery, then expanding its capabilities to include lamellar and penetrating keratoplasty, and now to capsulotomy and phacofragmentation in cataract surgery. Zoltan Z. Nagy, MD , clinical professor of ophthalmology, Semmelweis University, Budapest, Hungary, believes that eventually by Michelle Dalton EyeWorld Contributing Writer AT A GLANCE • Femtosecond lasers for cataract surgery have made “impossible” surgeries possible. • Not all patients make good candidates for femtosecond laser surgery. • While early results indicate the lasers can improve visual outcomes, long-term data is not yet available to substantiate claims of improved safety (i.e., reduced endophthalmitis). continued on page 18 most surgeons will be using a femtosecond laser in cataract surgery—much like how most LASIK flaps are created with a femto today. Uncomplicated cataract surgery, where no other comorbidities exist, is already an incredibly safe surgery, “so it’s hard to imagine being much safer,” said William W. Culbertson, MD , professor of ophthalmology, Bascom Palmer Eye Institute, Miami, Fla., USA, but when surgeons start discussing the femto for cataract, “we’re talking about having fewer complications and getting better outcomes in terms of vision while minimizing the damage to the cornea.” Reducing the number of maneuvers a surgeon must do lessens the amount of phaco energy required to the point where “we’re getting close to using no phaco energy at all,” Dr. Culbertson said, citing published work from H. Burkhard Dick, MD , and others. 1 The technology is still in infancy, and while pricing, surgical time, necessary skills, and learning curves can all be debated, “the technology works, and a lot more development should be expected in this field in the near future,” Prof. Nagy said. Safer than manual proce- dures? Femto for cataract “has the potential to increase the safety of cataract surgery because the precise corneal incisions, the