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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


    The limitations are that it performs keratometry only, does not incorporate preoperative measurements in the plan, requires a separate interface for measurements under laser, and uses “marking” incisions for toric IOL alignment, not virtual guidance, he noted.

    The LENSAR Laser System with Streamline is integrated wirelessly with the Cassini Corneal Shape Analyzer (iOptics) and has the following applications: iris registration, cataract density imaging, customized fragmentation patterns, and arcuate incision planning.

    Advantages of the system are that it measures the topography and the posterior corneal surface, and provides a reference image; integrates arcuate incision planning based on the surgeon’s nomogram; and performs imaging, registration, and guidance through a liquid interface. Toric IOL guidance may be achieved with small reference marks constructed by the laser on the corneal surface.

    Bausch + Lomb is currently developing a system (Spectrus) for image-guided surgery that will link preoperative topography to its femtosecond laser (Victus).

    “Femtosecond laser cataract surgery is safe, and offers improved incision construction and reduced effective phaco time,” Dr. Packer said. “There is a learning curve attached to the capsulotomy. The technology is effective in that it provides a superior uncorrected distance visual acuity.”

    He concluded that refractive cataract surgery has become significantly more efficient than previously because of image-guided surgery.

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