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Femtosecond laser provides added safety in management of complicated cataract cases
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 John D. Sheppard |
MILAN, Italy — Patients with complicated cataracts may receive the most benefits from the femtosecond laser approach, according to one surgeon here.
“The femto provides added safety in these cases,” John D. Sheppard, MD, said at the annual joint meeting of OSN and the Italian Society of Ophthalmology.
He discussed three examples of complicated cataract, the first of which was pseudoexfoliation.
“The capsule is weak and unstable, the zonule is loose, but the perfectly centered capsulorrhexis obtained with the femto stabilizes the position of the lens in the long term. The edges of the rhexis are twice as strong compared to the manual procedure, thus allowing better stabilization during surgery,” Dr. Sheppard explained.
The second example was Fuchs’ dystrophy, in which the endothelium is weak and subject to cell apoptosis during surgery in direct proportion to the amount of phaco energy and fluids circulating through the eye.
“Because the femto weakens the nucleus prior to placing the phaco in the eye, the total phaco energy is reduced by nearly 50%, preserving the endothelium in these patients,” he said.
The final example was the combination of cataract and glaucoma surgery. Before the cataract operation, Dr. Sheppard places a Trabectome (NeoMedix) to open Schlemm’s canal and reduce the pressure mechanically.
“With the femto, we perform just one incision initially, and both the Trabectome and phaco instruments can pass through it. The femto incision is multiplanar, seals well and there is no risk of leakage,” he explained.
- Disclosure: Dr. Sheppard is on the advisory board of Alcon.