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Femtosecond technology removes inconsistencies of cataract surgery
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MILAN — The use of femtosecond lasers in cataract surgery has the potential to eliminate inconsistencies of the procedure and to overcome current limitations in safety and efficacy, according to one speaker.
“All we do with cataract surgery is refractive nowadays. The technique has evolved but still is not safe enough, and efficacy and accuracy are not perfect,” Eric D. Donnenfeld, MD, said in the Benedetto Strampelli Medal Lecture at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology.
Eric D. Donnenfeld
The new technology, he said, “will allow cataract surgery to really come of age.”
“With a true three-plane incision, we can reduce wound leaks, which are the most common cause of endophthalmitis. With a more regular capsulotomy, we can effectively improve lens position, avoiding the most common cause of refractive error and fully exploiting the potentials of multifocal IOLs. By reducing the amount of energy, we have less trauma to the endothelium, less capsular tear and faster visual recovery,” he said.
Effective reduction of astigmatism can be achieved by femtosecond-created limbal relaxing incisions. According to Donnenfeld, the beauty of femtosecond technology is that the full effect is not achieved until the incision is opened, “like a postage stamp that is ripped off the matrix.”
“On the table, with intraoperative aberrometry, or any time up to 1 month postoperatively, the incision can be adjusted and then opened, giving us for the first time the ability to adjust and titrate the astigmatism,” he said. “Now we are beginning to do intrastromal ablation that will be very good for a small amount of cylinder.”
Disclosure: Donnenfeld is a consultant for Alcon, Abbott Medical Optics, Bausch + Lomb and LenSx.