FEMTOSECOND LASER
SPECIALISTS IN FEMTOSECOND LASER FOR CATARACT SURGERY
WHAT IS FEMTOSECOND LASER?
The femtosecond laser emits precise energy pulses of very short duration and near infrared wavelength, allowing it to penetrate tissues without damaging adjacent structures.
Its principle of operation is based on the photodisruption (separation) of tissues, achieving greater safety, accuracy and immediate recovery in our patients.
WHAT TYPE OF OCULAR PATHOLOGIES IS IT USED FOR?
Until now, this laser has been used in the field of ophthalmology for refractive surgery, in the correction of nearsightedness, farsightedness and astigmatism.
In recent years, this laser has been incorporated into the cataract surgery, which has meant a revolution in this type of intervention, as it reproduces the movements of the surgeon with total accuracy and safety, simplifying many steps of cataract surgery.
Its introduction represents a revolution in the current surgical procedure, as it modifies and provides significant advantages over the conventional phacoemulsification technique using ultrasound.
HOW'S FEMTOSECOND LASER SURGERY?
The femtosecond laser allows the surgeon to design a completely personalized treatment, assisting in the 5 fundamental steps of cataract surgery.
Step 1: Capsulotomy
One of the greatest advantages offered by the femtosecond laser is the high reproducibility, accuracy and reliability when performing circular and continuous cutting of the anterior capsule.
In addition, it allows the diameter to be adjusted according to the patient’s parameters while maintaining its accuracy. This diameter will be limited by the dilation of the pupil that requires a minimum size to be performed.
The precision of the capsulotomy is even more important in the “premium” intraocular lenses, since it allows a better centering and positioning of the lens in the capsular bag obtaining better refractive results.
Step 2: Fragmentation of the cataract
It starts at the deepest part of the waterfall and goes up towards the surface. This mode of action is due to the production of carbon dioxide as an effect of the laser photodisruption.
This step allows the selection of different types of patterns, depending on the hardness of the cataract: in very small quadrants for hard cataracts and in two halves for soft ones; being able to choose between multiple patterns depending on each case.
Thanks to this fragmentation we reduce the use of intraocular ultrasound, which may not be necessary in some cases.
Step 3: Incisions
They are designed according to the surgeon’s preference, delimiting his position, size, angulation and number of planes.
Its precision, reproducibility and visualization, by means of the OCT, allows to control all the previous parameters, obtaining a greater comfort of the surgeon and decrease of the effect of the astigmatism induced in the surgery.
In addition, we can select the length and inclination of the incisions to avoid being too corneal and thus reduce patient discomfort.
Step 4: Arcuatas Incisions
This step allows you to always make one or two incisions facing each other in order to reduce corneal astigmatism.
Its location, size and depth are determined by the surgeon based on the patient’s preoperative data.
Step 5: Intraocular Lens Implantation
Thanks to the femtosecond laser we get a better centering of the lens in the capsular sac.
FEMTOSECOND LASER FOR CATARACTS
Cataract surgery with femotosecond laser is benefited by making incisions exponentially more precise, with greater control of astigmatism and the performance of capsulotomy in a safer way, facilitating a better centering of the intraocular lens.
Conseguimos una disminución de la energía de ultrasonidos de hasta el 90% lo que conlleva menos efectos secundarios y una recuperación más rápida.
ADVANTAGES AND DISADVANTAGES OF THE FEMTOSECOND LASER
Advantages
- Safety: Increases safety in the 4 most important steps of surgery. The laser does not pierce the entire eye, it simply cuts the tissues in a closed chamber.
- Greater reproducibility.
- High degree of precision and accuracy.
- Decreases the time and ultrasound energy that the eye undergoes during surgery, thereby decreasing damage; recovery is accelerated and future visual outcomes are improved.
- Less sedation
- Less surgical time
Disadvantages
The high cost of the femtosecond laser, as well as the qualified personnel and disposable material, make the surgery have a higher cost than other interventions.
CONCLUSIONS
In summary, femtosecond laser is a technique that allows to improve the existing cataract surgery.
Its precision and safety has already been demonstrated in refractive and corneal surgery, so its application in the cataract surgery allows us to minimize damage to patients, improve recovery, reduce discomfort and optimize visual results.
