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Laser-assisted cataract surgery ready for ‘prime time’
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To the Editor:
As proponents of laser cataract surgery, we read the story, “Making the decision to transition to laser cataract surgery,” in the July 10, 2013, issue of Ocular Surgery News with great interest, but we found ourselves deeply concerned with a number of serious inaccuracies we encountered in your article. Unfortunately, these inaccuracies could mislead readers about their options when it comes to laser cataract surgery technology, especially with regard to the Catalys Precision Laser System (OptiMedica).
Among some of the noted issues:
- All of the listed laser cataract surgery systems are approved for arcuate incisions, including Catalys; in fact, OptiMedica received U.S. Food and Drug Administration clearance for this indication in September 2012.
- Catalys is also a “commercially available, full-featured laser-assisted cataract surgery platform” that is FDA-cleared and CE mark-approved for capsulotomy, lens fragmentation, corneal arcuate incisions, and corneal primary incisions and sideports; since its commercial launch in February 2012, the system has been purchased and installed at more than 60 leading ophthalmology practices around the world, with more than 200,000 eyes treated.
- The clinical performance of Catalys has been proven in 12 peer-reviewed papers and was the subject of 31 presentations at the 2013 American Society of Cataract and Refractive Surgery meeting alone.
- Overall, laser cataract surgery systems have been the subject of 38 peer-reviewed papers, and countless presentations at congresses around the world.
We both have had the chance to own and experience the first-generation laser cataract surgery platform (LenSx, Alcon) and will agree that the initial system presented limitations, but the technology has evolved significantly since it was first introduced. In fact, we both purchased the Catalys system when it received FDA clearance and have been impressed by the precision and accuracy it brings to even the most complex procedures. Our personal experience, which is supported by the clinical data in the literature, has shown that the Catalys system delivers virtually 100% complete capsulotomies, excellent effective lens positioning, excellent lens fragmentation and softening, reduction or elimination of ultrasound energy, less endothelial cell loss and shorter recovery time for patients. In addition, the system makes challenging cases, such as red, black and white cataracts; narrow-angle glaucoma; corneal guttata; Fuchs’ dystrophy and pseudoexfoliation, more routine. These benefits have been reported at medical meetings and in the literature.
We agree that laser cataract surgery systems are a significant investment, but we do not agree that laser cataract surgery technology is not ready for prime time or that surgeons might be better off waiting to purchase a system. The next-generation technology is here and has been tested, both anecdotally and through clinical studies. We, in fact, are comfortable with telling our patients that laser-assisted cataract surgery is not only more precise, it is frequently safer. Surgeons who have been waiting to adopt laser-assisted cataract surgery should no longer be on the sidelines.
Robert P. Rivera, MD Draper, Utah
Johnny L. Gayton, MD Warner Robins, Ga.
Disclosures: Rivera and Gayton are consultants for OptiMedica. Gayton is also a speaker for OptiMedica.