Highlights from Hawaiian Eye 2011: Femtosecond Laser Cataract Surgery

Femtosecond Laser Cataract Surgery - This panel discussion regarding what is currently the hottest topic in ophthalmology was led by experts from the three companies developing the technology: LenSx (Alcon), OptiMedica, and LensAR.

• Dr. Michael Knorz reviewed the need for this technology and how the laser can be used to create the corneal incision, capsulotomy, and lens fragmentation. He showed the LenSx results, which found statistically significant improvements in capsulotomy size, as well as reductions in phaco power, corneal endothelial cell loss, and variability in effective lens position when this technology was compared to standard manual phaco techniques.
• Dr. Barry Seibel discussed the various ways in which the laser can perform precise corneal incisions, both self-sealing wounds as well as relaxing incisions for astigmatic control. The accuracy and reproducibility of femtosecond lasers will also enable novel wound designs.
• Dr. Skip Nichamin presented results from lens softening in dense cataracts (LOCS grade 3 and 4) and how the LensAR femtosecond laser reduces the phacoemulsification energy (CDE on the Alcon Infiniti machine) required for lens removal, thus improving safety.
• Dr. Richard Lindstrom summarized the session and explained how this technology will change cataract surgery in the future.

A lively panel discussion followed the presentations with additional surgeons (Drs. David Chang, Roger Steinert, Eric Donnenfeld, Mark Packer, and Kerry Solomon) contributing their experience with these devices. There is no doubt that femtosecond laser devices will improve the precision and safety of cataract surgery. The big question is how to pay for the procedure and what economic models will be feasible.