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Future applications of femtosecond lasers may widen spectrum of minimally invasive procedures
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VIENNA — The spectrum of applications of femtosecond lasers will further expand in the future, widening the range of minimally invasive surgical options, according to a physicist speaking at the Advanced Retinal Therapy meeting.
One of these applications is presbyopia reversal in which the laser is used to soften the crystalline lens in order to restore accommodation.
Holger Lubatschowski, PhD
“The laser is used to generate sliding planes into the lens to reduce friction and make it more flexible,” Holger Lubatschowski, PhD, said.
This procedure, which has the advantage of not opening the eye, is showing promising results in an ongoing study of 220 patients.
Another interesting application, still undergoing preclinical investigation, is the “non-invasive bleaching of the human lens,” a procedure published some years ago by a Danish group.
“Kessel and co-authors found that if you decrease the energy below threshold, you do not cut but activate some non-linear interaction processes, something like photochemistry, through which you can make the lens clear again,” Lubatschowski explained.
The most exciting next frontier is the posterior segment of the eye, with many potential applications in vitreoretinal surgery, where the laser would work with very thin cuts, invisible by OCT, and without the need to open the eye.
“The reason why we are not doing it yet is that the laser cannot achieve in the posterior segment the precision it has on the cornea, due to the aberrations induced by the lens and vitreous. However, we have learned from astronomy how to measure the aberrations and shape the wavefront of the laser in order to compensate for them,” Lubatschowski said.
An adaptive optics OCT femtosecond laser system is currently under development. – by Michela Cimberle
References:
Kessel L, et al. PLoS One. 2010;doi:10.1371/journal.pone.0009711.
Lubatschowski H. Femtolaser in cataract surgery: Physics, possibilities, and limitations. Presented at Advanced Retinal Therapy meeting; Dec. 3, 2016; Vienna.
Disclosure : Lubatschowski reports he is founder and consultant of Rowiak.