Femtosecond laser may be used in combined cataract-vitrectomy procedures

PARIS — If the use of femtosecond laser becomes routine in cataract surgery, combined procedures such as cataract and vitrectomy will also integrate the new technology.

"To date, there is only one published retrospective series," Raphaël Adam, MD, said. "We need to do more, because combined femto-cataract and vitrectomy is likely to be the gold standard in the future."

Raphaël Adam

At the annual meeting of the French Society of Ophthalmology, Adam presented his first impressions of a prospective series of 10 patients treated with the combined femtosecond laser-assisted procedure at the XV-XX Hospital in Paris. The group was compared with an equal number of patients treated with the standard phacoemulsification procedure. The LenSx laser (Alcon) and Victus laser (Bausch + Lomb) were used in conjunction with the Constellation Vision System (Alcon). Vitrectomy was performed with a 25-gauge system.

Adam said that the femtosecond laser makes the combined procedure more precise and less traumatic, thanks to the centered, reproducible capsulorrhexis and less use of ultrasound energy.

"The total phaco energy delivered was 5 vs. 15 in the classical procedures," he said.

The limits he saw were the same reported by cataract surgeons: prolonged operating time and the need to move the patient from the laser to the surgical bed. Petechia was also more frequent, and miosis occurred more often.

Vitreoretinal surgeons need to become acquainted with this new technique, and the combination with 27-gauge vitrectomy may become the standard, Adam said.

Disclosure: Adam has no relevant financial disclosures.