Surgeons discuss present and future of femtosecond laser-assisted cataract surgery

BASSANO DEL GRAPPA, Italy — Femtosecond laser-assisted cataract surgery will become the state of the art in the coming years, although further developments of the technique and technology upgrades are needed, according to a panel of surgeons speaking at a meeting at the San Bassiano Hospital here.

“It’s still early days, and the technique is far from being perfect. As it is now, it requires longer times, and we don’t know yet how to improve some of the weak points of the procedure, such as hydrodissection. However, problems are there to be solved. We only need time, as we did when we switched from ECCE to phaco,” Simonetta Morselli, MD, the meeting organizer, said.

Simonetta Morselli

Femtosecond lasers have gained a significant market share in corneal surgery and LASIK, where clear advantages have been shown with laser-assisted procedures. However, industries might have pushed the femtosecond technology for cataract surgery too strongly and too early on the market, not allowing enough time for the technique to be developed and standardized by surgeons, Rita Mencucci, MD, said.

“They may be creating a demand we are not prepared to fulfill. There’s the risk that patients knock at our door expecting that if we do cataract surgery, we do it with the laser and in no other way,” Alessandro Galan, MD, said.

However, to those in the audience at the meeting who said that femtosecond laser-assisted cataract surgery is still “experimental” and that experienced surgeons perform procedures just as well manually as with the laser, and in a shorter time, Roberto Bellucci, MD, said that the laser technique has already proven itself.

“Evidence that it can improve cataract surgery has been provided by all the surgeons who are currently using it and who, having tried its numerous advantages, would not give it up,” Bellucci said.

In Italy, there are currently 12 femtosecond lasers for cataract surgery.

Disclosures: Bellucci is a consultant for Bausch + Lomb and receives research grants from Technolas Perfect Vision. The other surgeons have no relevant financial disclosures.