New Developments in Femtosecond Laser-assisted Cataract Surgery

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The peer-reviewed journal, US Ophthalmology publish a cutting-edge article authored by Michael Lawless and Chandra Bala looking at Femtosecond Laser-assisted Cataract Surgery

Scanning Electron Microscopy of  Capsulotomy Edges

Scanning Electron Microscopy of Capsulotomy Edges

Femtosecond laser technology enables precise incisions in the cornea & minimizes manipulations & energy required to fragment and emulsify the lens.

Cataract surgery is one of the most commonly performed surgical procedures worldwide. Between 2000 and 2020, the number of people aged 65 or over is projected to increase from 425 million to 677 million worldwide. This is likely to be accompanied by a corresponding increase in the incidence of cataracts and it has been estimated that by 2020, 32 million cataract surgeries will be performed annually (see Figure 1).

Phacoemulsification, the most commonly performed type of cataract surgery, requires manual creation of an opening in the anterior lens capsule, fragmentation and evacuation of the lens tissue with an ultrasound probe, and implantation of a plastic intraocular lens (IOL) into the remaining capsular bag. Femtosecond laser technology was approved by the US Food and Drug Administration (FDA) in 2010 for use in cataract surgery including the creation of surgical incisions in the cornea, formation of the capsulotomy, and lens fragmentation following initial clinical demonstrations of its efficacy.

Current femtosecond laser technologies use a near infrared femtosecond laser focused to a spot size of less than 6 μm. Femtosecond photodisruption is achieved by generating a plasma in the tissue. This plasma, comprising free electrons and ionized molecules, then expands and causes a shock wave, cavitation, and formation of a bubble, which expands and then collapses, causing tissue separation.

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Barney Kent
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