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Safety, efficacy and accuracy continue to improve with femtosecond laser cataract surgery
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ATLANTIC CITY, N.J. — Despite a few disadvantages, femtosecond laser technology has made deep inroads in cataract surgery, a speaker said here.
“I think this is the logical evolution of refractive cataract surgery,” Eric D. Donnenfeld, MD, OSN Cornea/External Disease Board Member, said at the Current Concepts in Ophthalmology meeting.
Eric D. Donnenfeld
Limitations of femtosecond laser techniques include a lack of precision, Donnenfeld said.
“It’s just not as precise as we’d like it to be,” he said. “Eventually, cataract surgery will become as precise as LASIK, with 98% of our patients seeing 20/20 or better. But right now, we have about half of that accuracy and also about half the safety.”
Emmetropia is achieved in 50% to 70% of patients who undergo femtosecond laser-assisted cataract surgery. The IOLMaster (Carl Zeiss Meditec) and the Lenstar (Haag-Streit) optical biometry systems have improved refractive accuracy, Donnenfeld said.
“One of the hopes for laser cataract surgery it that by having a consistent capsulorrhexis, you’ll have a better effective lens position,” he said. “You should end up with better vision and less differential results.”
Disadvantages of the technology include vitreous loss, difficulty with creating limbal relaxing incisions and loss of suction, Donnenfeld said.
“You can’t use gels when you’re doing this surgery,” he said.
Advantages include a 50% reduction in phacoemulsification power and time, improved incision design, reduced surgically induced astigmatism and reduced risk of postoperative endophthalmitis, Donnenfeld said.
New nomograms for femtosecond laser-assisted cataract surgery will soon be available on the American Society of Cataract and Refractive Surgery website, he said.
Disclosure: Donnenfeld is a consultant for Alcon, Abbott Medical Optics, Bausch + Lomb and LenSx.