This is a supplement to EyeWorld Magazine.
Issue link: https://supplements.eyeworld.org/i/605592
What do the recent technological advancements for femto cataract surgery mean? Femtosecond laser-assisted cataract surgery with the LenSx Laser (Alcon, Fort Worth, Texas) offers advantages over manual cataract surgery. Innovative high-definition visualization One of the benefits of the LenSx Laser over manual cataract surgery is optimal visualization, and both visualization and docking are quite easy. I can visualize every aspect of the procedure from beginning to end, which is a big advantage. Additionally, the LenSx Laser allows for quick centration. Another feature is the proprietary OCT technology, which is able to image down to a depth of 8.5 mm in a single image, without having to stitch multiple images together. It has high-definition imaging where the entire anterior segment is in clear view. It also has a zoom feature, which is helpful when finalizing the laser's surgical plan for capsulotomy and inci- sions. It helps maximize dialing in the precision of the laser treatments to a high degree and the precision of the surgical outcome. Reduced procedure time The timeliness of the scanning and imaging process is also important to help minimize suction time for the patient during the procedure. Once a patient is docked, the surgeon presses a button on the joystick, and the imaging, scanning, and auto-centration process occurs in seconds. The level of speed of this part of the process as well as the level of speed of the total laser treatment time and total procedure time is unique to the LenSx Laser. Typically, total procedure suction time is less than 2 minutes, and laser treatment time for all incisions, capsulotomy, and fragmentation is typically less than 30 seconds in total. A recent study conducted in Germany found that fem- tosecond laser-assisted cataract surgery with the LenSx Laser allows a significant reduction in effective phacoemulsification time, which correlates positively with the preoperative lens opacity. 1 The study included 150 eyes of 86 patients with senile cataract: 88 eyes underwent femtosecond laser-assisted surgery and 62 eyes underwent complete cataract remov- al performed with phacoemulsification only. Postoperative Pentacam (Oculus, Arlington, Wash.) nucleus staging showed no significant differences between the groups. Overall mean effective phacoemulsification time was 1.58±1.02 seconds in the femtosecond group compared to 4.17±2.06 seconds in the phaco group. Additionally, endothelial cell loss was signifi- cantly lower in the femtosecond group. Preserving the cornea The LenSx Laser procedure also has advantages for the cor- nea compared to manual cataract surgery. It offers excellent Effective phacoemulsification time comparison between femtosecond laser-assisted cataract surgery and manual surgery. Significant reduction in time in the femto (femtosecond laser-assisted cataract surgery) group (* = significant difference between groups; P=0.001). Source: American Journal of Ophthalmology Mean effective phacoemulsification time in PNS-O (Pentacam automated nucleus staging; ordinal scale) stages (* = significant difference between groups: manual surgery [manual] and femtosecond laser-assisted surgery [femto]; P<0.01). Source: American Journal of Ophthalmology by Kerry Solomon, MD Femtosecond laser-assisted cataract surgery offers benefits for surgeons, patients precision for all incisions and arcuate incisions that can be left open or closed. There is less endothelial cell loss, less corne- al edema, and clearer corneas the day after surgery. 2 A study conducted in Italy found that the femtosecond laser cataract procedure was efficient and less damaging than manual cata- ract surgery, as was demonstrated by lower central endothelial 4 For important product information, please see page 8.