EyeWorld Asia-Pacific September 2014 Issue

48 EWAP CAtArACt/IOL September 2014 Dr. Daya, using the Victus platform, applies the suction ring to the patient’s eye. Following femtosecond laser capsulotomy and lens fragmentation, the retracted peripheral capsule confirms a free-floating capsule and a single inferior quadrant combines radial cuts and a quadrant of rings to facilitate removal. Source (all): Sheraz Daya, MD by Ellen Stodola EyeWorld Staff Writer Global reception of femtosecond laser cataract surgery The new technology is being used differently around the world T he reception and utilization of the femtosecond laser in cataract surgery has been different around the world, depending on a number of factors. Jorge Alió, MD, PhD , medical director of VISSUM, Alicante, Spain; Burkhard Dick, MD , chairman, University Eye Hospital, Bochum, Germany; Michael Lawless, MD , Vision Eye Institute, and clinical associate professor, Sydney Medical School, Australia; Sheraz Daya, MD , FACP, FACS, FRCS(Ed), FRCOphth , chairman and medical director, Centre for Sight, London; and Peter Barry, FRCS , head of the Department of Ophthalmology, St. Vincent’s University Hospital, AT A GLANCE • Many surgeons agree that a major limiting factor with the femtosecond laser is the price, and a number of facilities have not yet acquired the technology for this reason. • Using the femtosecond laser is considered a premium procedure, which often comes with an added cost to either the surgeon or patient. • A study is currently being undertaken to compile data on consecutive femtosecond laser cases. and senior retinal surgeon, Royal Victoria Eye and Ear Hospital, Dublin, discussed the topic of femtosecond cataract surgery and implementation in their countries. Adoption in various countries Dr. Alió said that the adoption of femtosecond cataract surgery in his area has been minimal. “There is only one device and patients are not particularly attracted by the technology,” he said. “Promotion has not been important because the patients have found it difficult to understand the benefits of this technology and are especially sensitive to the high cost involved.” Dr. Dick said that the use of the femtosecond laser in cataract surgery has rapidly expanded in Germany. Since December 2011, he has performed more than 2,900 femtosecond cases on a commercial basis. “Adoption of [femtosecond] cataract surgery has had a slow start in the UK,” Dr. Daya said, with the first few lasers installed mainly in ophthalmologist- owned private ambulatory surgery centers from December 2011 to June 2012. “More lasers have since been installed in private centers with one corporate group recently acquiring 6 lasers for their institutions,” he said. The first femtosecond laser cataract surgery in Australia was done in April 2011 by Dr. Lawless. The lasers are currently available in capital cities and some regional centers, in large private hospitals, as well as standalone ambulatory surgery centers. So far, the lasers are not in the public sector or teaching hospitals. Adoption has been relatively easy compared to other countries because Australian patients are familiar with a co- payment system, he said. Limiting factors Dr. Lawless said some surgeons lack access to the laser because their ASC or hospital has not invested the capital required to place the units, and some regional centers and small hospitals have low volumes of cataract surgery and cannot justify placing a device on financial grounds.