PUBLICATION EXCLUSIVE: Could femtosecond laser technology encourage more cataract surgeons to perform primary posterior capsulotomy and optic capture?

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Femtosecond laser is a game changer

Yes, as far as primary posterior laser capsulotomy (PPLC) is concerned. By doing femtosecond laser-assisted cataract surgery with standard in-the-bag implantation, 3-D spectral-domain OCT has shown us how wide Berger’s space is after cataract surgery. First, because there is fluid movement through the zonules behind the posterior capsule, balanced salt solution and fluid are turning all round. Second, because the patient is in the supine position, gravitation and partially liquefied vitreous widen the space. Third, because the crystalline lens is removed and even with an IOL in place, there is still sufficient additional space. OCT is consistently able to visualize the posterior capsule, and you set the laser and perform the capsulotomy in a fully automated way. No special surgical capabilities are needed, and there is no danger of damaging the IOL or the vitreous. PPLC never had a great chance in cataract surgery because surgeons understandably were afraid of touching the posterior capsule, but the femtosecond laser is a big game changer. PPLC can now become routine, with the remarkable advantage of preventing PCO forever. Health care can save billions by eliminating the need for YAG capsulotomy, and the patient can avoid visual distortion, flare and halos, maintain the vitreous intact and prevent future problems with, for example, retinal detachment, macular edema and glaucoma.

Click here to read the full publication exclusive, Point/Counter, published in [cular Surgery News U.S. Edition, June 25, 2017.