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    Femtosecond laser surgery still raising bar for cataract surgery outcomes

    Surgeons, technologies striving to meet patient demands; key to safety, effectiveness, efficiency

     

    Effectiveness

    A recent comparison (Chee et al. Am J Ophthalmol. 2015;159:714-719.e2) of the uncorrected visual acuity levels after femtosecond laser cataract surgery and conventional phacoemulsification in eyes with a targeted spherical equivalent of ± 0.5 D showed that the former provided patients with significantly better results.

    Thirty-eight percent of eyes versus 28.2%, respectively, achieved 20/20 or better vision 6 weeks postoperatively, and 68.9% and 56.4%, respectively, achieved 20/25 at the same time point (p = 0.02, and p = 0.00, respectively).

    Efficiency

    These results are likely due to the advanced imaging and guidance systems that are now available or will soon become available to surgeons, Dr. Packer summarized. These include:

    • Verion Image Guided System (Alcon Laboratories)
    • cOS 4 (Advanced Medical Optics) with its Steep Meridian Registration Technology (SMRT)
    • Spectrus (Bausch + Lomb) with iris registration and guidance
    • Streamline (LENSAR) with corneal analysis, registration, and guidance

    The Verion reference unit can perform keratometry and pupillometry and provides a reference image. The advantage of the Verion system include toric IOL planning; the limitations are the solid interface and the ability to perform keratometry only (no posterior corneal surface measurement).

    SMRT performs keratometry with a non-contact interface and iris registration.

    In addition, surgeons can create toric alignment arcuate incisions.

    Dr. Packer pointed out that the benefit is that SMRT measures the keratometry through the laser optics.

    Limitations and advantages

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