Idea of using femtosecond lasers during different stages of cataract surgery send us back to the days when Nd:YAG laser was proposed to be used for posterior capsulotomy for the first time. Recently, the interest in these lasers has grown dramatically, since a few companies such as LenSx Lasers, LensAR and Optimedica made it possible to transfer femtosecond laser technology into cataract surgery. The new lasers not only allow to remove the lens, but also make it possible to perform capsulorhexis to the highest accuracy as well as to correct astigmatism with the help of limbal relaxing incisions. At the moment, only LenSx has been approved by the Food and Drug Administration (FDA). Two other lasers are being tested.
Roger F. Steinert, the director of Gavin Herbert Eye Institute, thinks that femtosecond laser technologies allow to improve cataract surgery at various stages such as the creation of corneal cut, capsulorhexis, and breaking up the nucleus. According to William W. Culbertson, refractive surgeon at Bascom Palmer Eye Institute, the femtosecond laser enables surgeon to perform phacoemulsification with a higher precision and more predictable results at the most difficult surgery stages that can be fraught with following complications. He believes that femtosecond laser will soon become indispensable with a view to cataract surgery, especially in last-generation IOL implantation. In addition, he ensures the capsulorhexis will have a specified diameter and precise centration, as the key value of this method is that it must be linear, uninterrupted and centered.
Many ophthalmologists such as Dr. Boothe of Boothe eyecare have already been interested in prospect of adoption of femtosecond lasers in cataract surgery. Representatives of ophthalmologic companies such as LenSx Lasers, Optimedica and LensAR tell that their laser technology makes it possible to create incisions and to perform capsulorhexis to the highest accuracy as well as to soften the nucleus and thus shortening the working time of ultrasound. Due to the newest technology, both effectiveness and safety of cataract surgery improve considerably. At the moment researches to study potential of femtosecond lasers in this ophthalmology field are in progress.
According to Louis D. “Skip” Nichamin, the Medical Director of the Laurel Eye Clinic, one of the undoubtful advantages of the technology is possibility to create limbal relaxing incisions. He presented the results from 50 patients utilizing LensAR system. It was found that diameter for capsulorhexis performed with laser is far closer to desired value compared to the manual lens removal. In addition, the laser technology enabled to perform capsulorhexis procedure more precisely. Dr. Chang, Medical Monitor LensAR Inc., said that he had been amazed at the accuracy and reliability achieved during the performance of capsulotomy as well as the effectiveness and quickness of phacoemulsification against the background of prior softening of the lens nucleus. Robert H. Osher, M.D., professor of ophthalmology at University of Cincinnati, has strong hopes that the tendency of new technology introduction in cataract surgery will continue in the nearest future, and the surgery will become more effective and safe.