Femtosecond Laser Cataract Surgery – Is This The Future?

• 1. 1 FEMTOLASER CATARACT SURGERY Something to think about Dr Ross Ferrier Gosford and Wyong Eye Clinics

2. Manual Cataract Surgery Today 2 temporal clear corneal incisions Create a 6mm opening in the lens capsule (capsulorhexis) that is as circular and central as possible Fragment the clouded lens with surgical instruments and ultrasound energy Carefully remove all remaining lens cells with aspiration An artificial intraocular lens (IOL) is then placed in the capsular bag and positioned as necessary 3. CORNEAL INCISIONS Not optimised Variable degree of entry Variable resulting astigmatism Variable degree of infection risk and iris prolapse from wound leak 4. CAPSULORHEXIS Variable Shape Size Location on axis Effects on the position of the implant 5. LENS FRAGMENTATION Variable technique Chop Stop and chop Divide and conquer Lens flip Aim to remove the lens with the lowest possible energy and the lowest risk to the corneal endothelium 6. ASPIRATION Remove as much of the remaining lens cell population as is possible to minimise the risk of capsule fibrosis and posterior capsule opacity 7. WHY LASER CATARACT SURGERY? 8. Femtosecond laser Femtosec laser causes tissue disruption with its near-infrared scanning pulse focused to 3um with an accuracy of 1um The focused laser energy generates plasma which expands, causing a shock wave, cavitation and bubble formation The bubble expands and collapses causing separation of the tissue No heat damage due to laser properties. 9. Advantages Precise programmable corneal incisions Accurate capsulorhexis size, shape and centration Reduction in power and time with unique fragmentation patterns Arcuate incisions 10. Manual vs. Femtocataract Surgery 1 month postop Manual Surgery Femtocat Surgery MK-00251 Rev A 11. More predictable outcomes More predictable shape ? Better outcomes Catalys Clinical Results: Capsulotomy Shape Manual Capsulorhexis Catalys Capsulotomy MK-00251 Rev AImages courtesy of OptiMedica Corp. 12. Catalys Clinical Results: Capsulotomy Size Manual (Mean SD) Catalys (Mean SD) Deviation from intended diameter 339 m 248m 29 m 26 m (p