Controversies in Femtosecond Laser-Assisted Cataract Surgery
Controversies in Femtosecond Laser-Assisted Cataract Surgery
Cataract surgery performed by phacoemulsification is an elegant surgery, but recent advances in technology offer the potential to further enhance the cataract surgery experience for patients and ophthalmologists as well as improve outcomes. Certain steps of traditional cataract surgery performed by phacoemulsification may soon be performed with increasing frequency by the femtosecond laser.
Phacoemulsification can be traumatic to the corneal endothelium with increasing amounts of ultrasound energy correlated with worsening postoperative corneal edema and inflammation; thus, minimizing the amount of phacoemulsification energy used during cataract surgery has been a long-standing goal. The incorporation of the femtosecond laser to perform certain steps of cataract surgery, known by multiple acronyms (ReLACS—refractive laser-assisted cataract surgery; FLACS—femtosecond laser-assisted cataract surgery; FALCS—femtosecond-assisted laser cataract surgery, LCS—laser cataract surgery), offers potential benefits over traditional cataract surgery including reduction in phacoemulsification time as well as reduction in surgery time, improvement in lens positioning, safety, accuracy, clinical outcomes, and achievement of more reliable and precise capsulorhexis and corneal incisions.
Since the introduction of the femtosecond laser for creating lamellar flaps in laser in situ keratomileusis in 2001, femtosecond lasers have been developed and approved for cataract-assisted surgery. Early experience from femtosecond cataract surgery in postmarketing evaluations began in early 2009. Six years later, femtosecond cataract surgery is becoming more available to cataract surgeons in the United States; however, many questions remain about the future of this technology. We will review the technology, available platforms, steps of femtosecond laser cataract surgery, highlight early published results, and discuss the role of femtosecond cataract surgery in surgical learning curves and resident education.
Abstract and Introduction
Introduction
Cataract surgery performed by phacoemulsification is an elegant surgery, but recent advances in technology offer the potential to further enhance the cataract surgery experience for patients and ophthalmologists as well as improve outcomes. Certain steps of traditional cataract surgery performed by phacoemulsification may soon be performed with increasing frequency by the femtosecond laser.
Phacoemulsification can be traumatic to the corneal endothelium with increasing amounts of ultrasound energy correlated with worsening postoperative corneal edema and inflammation; thus, minimizing the amount of phacoemulsification energy used during cataract surgery has been a long-standing goal. The incorporation of the femtosecond laser to perform certain steps of cataract surgery, known by multiple acronyms (ReLACS—refractive laser-assisted cataract surgery; FLACS—femtosecond laser-assisted cataract surgery; FALCS—femtosecond-assisted laser cataract surgery, LCS—laser cataract surgery), offers potential benefits over traditional cataract surgery including reduction in phacoemulsification time as well as reduction in surgery time, improvement in lens positioning, safety, accuracy, clinical outcomes, and achievement of more reliable and precise capsulorhexis and corneal incisions.
Since the introduction of the femtosecond laser for creating lamellar flaps in laser in situ keratomileusis in 2001, femtosecond lasers have been developed and approved for cataract-assisted surgery. Early experience from femtosecond cataract surgery in postmarketing evaluations began in early 2009. Six years later, femtosecond cataract surgery is becoming more available to cataract surgeons in the United States; however, many questions remain about the future of this technology. We will review the technology, available platforms, steps of femtosecond laser cataract surgery, highlight early published results, and discuss the role of femtosecond cataract surgery in surgical learning curves and resident education.
Source...