Regional EuroTimes
Date Posted 15/09/2009
Femtosecond cataract surgery demonstrates high precision compared with manual procedure
In more than 250 cases on sighted patients to date, cataract surgery guided by OCT imaging has consistently produced more-precise capsularhexis without any radial tears or adverse events, said Zoltan Nagy MD, Hungary. The system also liquefies the lens, and creates perfectly aligned incisions in support of refractive cataract surgery, Dr Nagy added.
For the capsularhexis, the laser creates a cylindrical cut starting just below the capsule and progresses superiorly until the entire cap is cut, Dr Nagy said. The incision is completely free, demonstrating that there are no adhesions, and the cut portion can be removed by simply grasping it with forceps.
“The laser creates a uniform capsulotomy with edge features at least as smooth as manual anterior capsulotomy, which could be important in preserving the strength of the capsule and preventing radial tears,” Dr Nagy said. His study of 60 laser procedures compared with 60 manual procedures found that all laser procedures were perfectly centrated and within 0.25 mm of the target size. Only 10 per cent of the manual procedures were within 0.25 mm accuracy.
The laser liquefies the lens by cutting a series of concentric circles focused on the nucleus to soften it after hydrodissection. The laser also can be used to soften or chop the lens. Power can be adjusted to ensure complete liquefaction of a dense nucleus, Dr Nagy said. The treated nucleus is then easily aspirated, he said.
The system takes a pre-operative OCT image and creates a map that guides the laser during surgery. All patterns can be pre-programmed and adjusted for precise surgeon control. Dr Nagy believes it could deliver superior vision outcomes in refractive cataract procedures.
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