Eyeworld Supplements

I received the first U.S. VICTUS ® femtosec- ond laser (Bausch + Lomb, Bridgewater, N.J.) around Labor Day 2012, and it was wonderful. But like any computer-driven system, there was room for improvement. There were certain steps—like the little rest it would take between the lens fragmen- tation to the corneal surface portion—that I wished could speed up a bit, for instance. The latest upgrade has not only sped up those steps, which can contribute to improved patient comfort, it has also added swept source OCT, which is a live streaming imaging technology with much higher defini- tion and allows the surgeon to see where the eye is at all times. All of the other technologies are taking snap shots that may be repeated but are always a few moments behind. In the mean- time, the patient's eye could have turned a little, unbeknownst to the surgeon. With live streaming we see exactly what that eye is doing and in higher definition than any ultrasound we have ever had before. The difference allows you to know that you are cutting where you think you are cutting and to do so a little more precisely. In the past, if the patient moved it wasn't necessarily dangerous but you weren't getting the depth of a cut you wanted, which led to the need for more of the traditional work on the back end of the procedure. Premium vision series 2 perform the capsulotomy, lens fragmenta- tion, arcuate incisions, and entry incisions very quickly, and this leads to less time spent inside the eye once the intraocular part of the procedure begins. This speed is brought about by efficiency and leads to less complications in my hands. Speed means little if I need to see the patient for twice as many office visits to address a problem. My advice for surgeons who have not used the VICTUS ® laser would be to remember that not all femtosecond lasers are created equal. While the basic elements of femtosecond lasers are the same, key differ- ences include their energy, spot size, and den- sities. That is likely one reason that across the United States we get such a high free-floating capsulotomy rate with the VICTUS ® laser. The differences of this system are why its users do not face the same frustrations with opening corneal incisions that users of some other femtosecond systems have complained about. Instead, my corneal incisions open 99% of the time, and my arcuate incisions do not re- quire titration. I can use the same nomogram that I used with a blade. So there are critical differences between femtosecond lasers. I urge prospective femtosecond owners to visit a physician using a VICTUS ® system through the Bausch + Lomb site visit program and learn the benefits of the new software that recently came out. Observe it working because its performance and the swept source OCT will blow you away. Dr. Whitman is chief surgeon at Key-Whitman Eye Center in Dallas, Texas. He can be contacted at whitman@keywhitman.com. continued from page 1 VICTUS ® femtosecond laser user interface Source: Michael Endl, MD Versatility across multiple applications by Michael Endl, MD continued on page 3

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