Since the introduction of femtosecond laser pretreatment in cataract surgery (LCS), research has been directed toward determining its efficacy compared with conventional phacoemulsification (manual) techniques. Collectively, surgeons at our facility have performed over 750 cases of LCS. We have recently published comparative parallel cohort data, comparing our first 200 cases of LCS with 200 cases of manual cataract surgery (MCS) and our research continues including measuring LCS impact on IOP, cornea, refraction, inflammation and OCT, as well as improved operative techniques.
The advancement in Femtosecond lasers has been remarkable, though debate continues about whether to become involved with the technology based on clinical efficacy and safety. The Catalys laser (Optimedica, Sunnyvale, California, USA) that our practice acquired in April 2012 has since had multiple upgrades — in particular improving power efficiency and accuracy. The most recent upgrade has reduced anterior capsulotomy time to less than 2 seconds, provided corneal incisions and dramatically reduced lens fragmentation times as well as enhancing the treatment zone. These improvements highlight that this technology has not yet reached maturity.
The Optimedica Catalys platform is intuitive and guides the operator through the treatment planning steps with ease. Intelligent force vectors monitor the patient's eye movements and the laser will stop if the patient moves beyond the OCT guided iris and anterior and posterior capsule safety zones.
Another safety feature of the platform is the liquid optics interface, which causes only a small and transient rise in IOP.1 This is important for our elderly cataract patients who have significant co-morbidities such as glaucoma.
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