When I became interested in adding laser to my cataract surgeries in 2011, I chose the Catalys system (Abbott) because it offered several features I believed would be advantageous for the surgery.
For instance, the the system was introduced with a non-applanating liquid interface that holds the eye firmly in place to minimise eye movement during the procedure. This is important, as respiratory movement of the eye during the capsulotomy step has been suggested as a potential risk factor for capsule tear.10 The liquid optic interface also minimises increases in IOP.11
The system also came equipped with an advanced imaging system, which I foresaw would be important for scanning the eye and preparing the treatment plan.
The accuracy of the imaging would also be crucial for individual capsulotomy centration. Over the years, 3-D spectral-domain optical coherence tomography (OCT) has been added to make the imaging capabilities even stronger.
The system is also extremely fast, with the ability to achieve a full lens fragmentation in less than 30 seconds in most kinds of cataracts. Treatment time may be a little longer in higher-grade cataracts.
However, the laser fragmentation option is much more gentle than the turbulence that would be created by using ultrasound energy to emulsify dense cataracts, and so a slightly longer fragmentation cycle with laser is still preferable over manual techniques in these cases.
These features on their own are important; how they can be used in tandem to complement one another may be even more important.