Femtosecond laser with integrated OCT enables safe, precise cataract surgery

Sci Transl Med. 2010;2(58):1-9.

Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography and advanced guidance software had good results, a study showed.

Surgeons used the Catalys Precision Laser System (OptiMedica) to perform capsulotomy, lens fragmentation, clear corneal incisions and limbal relaxing incisions.

"The continuous sharp-edged capsular cuts improved the strength of the capsule, reducing the risk of its rupture during phacoemulsification and IOL insertion," the study authors said. "Lens segmentation and nucleus fragmentation simplified its emulsification, and were especially advantageous with dense cataracts. A multiplanar corneal cut provided for a self-sealing cataract incision."

The randomized, case-controlled clinical study included 59 eyes of 50 patients; 29 eyes underwent femtosecond laser-assisted cataract surgery and 30 eyes underwent manual surgery.

Frequency-domain OCT was used to acquire three-dimensional images and map the crystalline lens and anterior chamber. The software identified the anterior and posterior surfaces of the lens, cornea and iris.

Study results showed that laser-treated eyes gained a mean 4.3 lines of best corrected visual acuity and control eyes gained a mean 3.5 lines. The between-group difference was statistically insignificant.

"Nevertheless, similarity in the visual outcomes of the laser and manual surgery confirm safety of the laser treatment and lack of side effects on visual function," the authors said. "Evaluation of the superiority of the visual outcomes with the laser treatment will require a large comparative clinical trial."

Capsulotomy strength in laser-treated eyes more than doubled that of manually treated eyes. Laser cutting significantly softened cataracts and eased their removal.

No laser-related adverse events were reported, the authors said.