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BLOG: Wish list for femtosecond cataract surgery
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As a relative latecomer to femtosecond cataract surgery, I’m impressed by the technology’s ease of adoption and delivery of the promised “goods” — more precise capsulotomy and incisions and lower phaco time through lens fragmentation. From the surgeon’s perspective, though, I see a number of opportunities of improvement. Here, just in time for Christmas, is my wish list for femtosecond lasers:
More integration into phaco surgery
Ideally, these lasers could be configured with a sterile surgeon interface, allowing a gowned surgeon to go directly from femto to phaco. A draped keyboard and mouse could protect the surgeon from contamination, and just a little modification of the patient interface would allow it to be used on a prepped, draped patient.
I use two ORs, and even with only one laser, we can work out the logistics of patient flow. The time savings and prevention of miosis would be valuable if we could complete this procedure in one compound laser-phaco step, all in one room.
Integrate the temporal clear corneal penetrating incision with AK
Many patients have against-the-rule astigmatism, requiring a temporal relaxing incision, but the two lasers we own, AMO Catalys and Alcon LenSx, are not able to deliver a single incision that penetrates to 80% depth for astigmatism control and access for phaco, as I would create in a non-femto case. This seems like an easy modification to existing platforms, and it would improve care for a meaningful subset of patients.
Patient-assistance program
There are many cases in which a financially strapped patient could benefit from femtosecond cataract surgery. A simple, easy-to-navigate assistance program would be greatly appreciated and could be limited to a fixed percentage of a surgeon’s cases. Most companies have these programs available and are indeed community-minded. Simplifying the application process would have a small but real public health benefit.
I’m excited to be on board with femtosecond cataract surgery and look forward to the great technical advances ahead. Please comment on your own wish list for this procedure.