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Femtosecond laser and the novice cataract surgeon
One of the highlights of my week is spending time in the operating room with ophthalmology residents, because they are bright, hard-working and eager to learn as much as possible. This past week, they asked me about the use of femtosecond laser to assist with cataract surgery since I've slowly begun using it at our surgery center in Beverly Hills. While I think that the femtosecond laser can in certain ways improve my cataract surgical procedure, I think it can have a far greater benefit in helping more novice surgeons.
After having performed thousands of cataract surgeries, I know that my technique is very refined and the results are excellent. Since I have done so many live surgery events at the major meetings, many fellow ophthalmologists have seen me operate live and under pressure. But when you see a postoperative patient of mine, you'll notice just a few things that reflect the original procedure: the incisions, the capsulorrhexis and the lack of iatrogenic trauma. In a resident case, these are exactly the tough parts of the surgery: making a well-constructed incision and tearing a round, well-centered, properly sized capsulorrhexis.
With the femtosecond laser, novice surgeons will now have the ability to deliver a beautifully constructed incision and a perfect capsulorrhexis for every case. And for those who find learning phaco chop difficult, no worries, as the femtosecond laser will also divide the nucleus into quadrants for you. It sounds great until the beginning surgeon encounters a case with a small pupil or an opaque lens, and the femtosecond laser energy cannot be delivered into the appropriate tissues. Looks like they'll still need to learn the traditional manual techniques and that my passion for teaching ocular surgery to young surgeons is still needed.