Technology poised for next level

Femtosecond laser-assisted procedures continue to be a focus of attention in cataract surgery as manufacturers and surgeons aim to elevate efficacy and safety outcomes to a higher level.

Orlando, FL-Femtosecond laser-assisted procedures continue to be a focus of attention in cataract surgery as manufacturers and surgeons aim to elevate efficacy and safety outcomes to a higher level.

In a session devoted to laser refractive lens surgery at Refractive Surgery Subspecialty Day, during the annual meeting of the International Society for Refractive Surgery/American Academy of Ophthalmology, speakers provided updates on platform features and study results for four systems (Victus, Bausch + Lomb/Technolas PV; Catalys, OptiMedica; LenSx, Alcon Laboratories/LenSx; and LensAR Laser System, LensAR).

Victus

Noteworthy features of the Victus laser include its curved patient interface with sensors (Intelligent Pressure Control) that prevent excessive pressure during docking. The curved interface is also redesigned to reduce applanation of the cornea and minimize corneal deformation and rippling. Imaging and intraoperative guidance are provided by online optical coherence tomography (OCT).

Dr. Auffarth noted that evaluations in various studies comparing laser-assisted versus manual capsulotomies show that the two capsular openings are comparable with respect to edge smoothness. However, laboratory testing demonstrates that the edges of the lasercreated capsulotomies are much stronger and more resistant to tearing.

Dr. Auffarth also reviewed his positive experience using the femtosecond laser to create the capsulotomy and fragment the lens in a small series of cataract surgery patients that represented a range of challenging cases, including black and brunescent cataracts and eyes with pseudoexfoliation syndrome and zonular atrophy.

"Our first patient had a black cataract with preoperative visual acuity of hand motion and a postoperative result of 20/20," he said. "Despite the very dense cataract, it was possible to create a very nice capsulorhexis and perform pre-fragmentation of the lens.

"Although our experience is limited in number and to extreme cases, colleagues in India have used the Victus to perform cataract surgery in about 400 eyes with good results," Dr. Auffarth added. "We recognize this is still the beginning of a new technology, but we are looking forward to the future."