New findings in Cataract Surgery and the LenSx® Femtosecond Laser System—2015 Update

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US Ophthalmic Review, a peer-reviewed, open access, bi-annual Ophthalmology journal publish cutting-edge article by Sarah Makari and Richard Potvin.

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This article provides an updated review of the LenSx® femtosecond Laser system, including recent system modifications and the most- recent published literature.

Femtosecond laser-assisted cataract surgery continues to gain popularity as clinicians adopt the technology with the desire to improve the safety and efficacy of cataract surgery. The technology continues to evolve as clinical experience points to improvements to better meet the needs of surgeons and patients. The effect of these system updates, and the increasing body of experience with femtosecond laser systems, has reduced complication rates and seen the technology applied to more challenging cases. This article provides an updated review of the LenSx® femtosecond Laser system, including recent system modifications and the most- recent published literature.

Safe and effective cataract surgery is the goal for both patients and surgeons, with increasing demands for accurate refractive outcomes. Femtosecond laser-assisted cataract surgery (FLACS) is arguably the most significant change to cataract surgery since phacoemulsification, the adoption of which is in large part fueled by the desire for more precise and safe surgery with more predictable outcomes. In the past two years, the use of femtosecond laser systems has increased dramatically. An estimated 250,000 surgeries have been performed with these systems.1 One of the earliest and most-studied laser systems is the LenSx® Laser system (Alcon Laboratories, Inc., Aliso Viejo, California). The purpose of the current review is to update the reader on the most recent innovations of the LenSx® Laser system and the latest studies discussing clinical results.

The LenSx® Laser system uses an optical coherence tomography (OCT) and video imaging to view and plan the treatment steps, which are generally customizable by the surgeon and tailored to the patient’s needs. Clinical studies have demonstrated that the incorporation of the laser for lens fragmentation, capsulotomy, and incisions is safe and effective. Results from a large dataset showed that the surgical outcomes of FLACS was comparable to the best standard cataract surgical outcomes. The accurate positioning of capsulotomies appears to improve intraocular lens (IOL) overlap, which is expected to enhance IOL positioning and minimize IOL calculation errors. This is of particular importance for eyes with short or long axial lengths where calculating accurate IOL power is challenging and also for eyes receiving advanced technology IOLs where there are high expectations for precise refractive results.

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Barney Kent