Technological requirements for adaptation

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Is it possible to adapt current femtosecond lasers to perform cataract surgery?

"There are five femtosecond laser systems on the market that perform their job pretty well in corneal surgery. They are femtosecond lasers, their interaction is based on photodisprution and they cut the cornea," he continued. "Recently we have had another group of femtosecond lasers become available that also perform photodisruption of the eye, however, these do not do it on the cornea but on the lens."

Looking into these systems further and trying to answer the question of adaptability, Prof. Lubatschowski examined the technological similarities and differences of the lasers.

"A similarity between these lasers is the photodisruption process," Prof. Lubatschowski said. Both use femtosecond pulse duration for this process, which is beneficial for precision - short pulses allow for higher precision. Using these femtosecond pulses in the range of nanoJoule to microJoule energy allows the lasers to reach the intensity threshold required to disrupt the relevant tissue without too large cavitation bubbles being formed and with much more control.

Additionally, the wavelength of the lasers are the same. "1000 nm is at least the cheapest wavelength available to produce femtosecond pulses and that's why all these lasers have wavelengths in that range, which is capable of penetrating the eye," he added.

Application of the lasers is a further similarity, with both requiring eye fixation and the patient-laser interface either being matched by moving the patient bed or the laser mirror arm of the system.

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Josefina Botta, MD, MSc, at ASCRS 2024
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