What you need to know about Femtocataract Surgery?

At the moment surgery is the only effective treatment for cataract. Now you need to get the cataract affected natural lens replaced by a new IOL (intra ocular lenses) by surgery.

Read on for an insight to Femtocataract surgery.

What is Femtocataract surgery?     

Gone are the days where you had to wait in dark glasses in pain for days for clear vision after a cataract surgery. With the advances in ophthalmology procedures like Femtosecond laser-assisted cataract surgery (FLACS) a novel revolution in Cataract Refractive surgery has paved its way. As the name suggests the major difference here is the use of a Femtosecond laser controlled by the surgeon.

The edge over the conventional phacoemulsification lies in major surgical steps as noted below.

The first few steps in a cataract surgery involve the creation of corneal / corneo-scleral incisions (ports of entry) and capsulorhexis – creation of an incision in the front surface of the lens capsule, to enable removal of the cataract affected lens. Both these steps today are under the manual skill of a cataract surgeon. The phacoemulsification steps begin with the ‘chopping’ of the lens, breaking it down into smaller fragments to aid removal through a small incision, thus avoiding the need for stitches.

All above steps can be substituted with a good Femtosecond laser. However, it cannot substitute phacoemulsification in cataract surgery. The aspiration of the lens completely will still require the phacoemulsification equipment.

Thus it serves as a good aid to reduce complications, improve accuracy, safety and precision in cataract surgery.

Clear Corneal Incisions-

It is faster and safer to have incisions (surgical cuts) being computer-controlled with imized precision that can be customizable according to your eyes. Incisions made by the laser have a clear cut edges which results in quick sealing and healing, letting you have a satisfied refractive post operative outcome on day 1 of surgery itself.

Capsulotomy (Capsulorhexis) – Creation of the Opening made on the lens covering is done by dissecting with unmatchable precision which aids in perfectly positioning the implanted IOL.

Lens Fragmentation –Initial fragmenting (breaking up) of the lens to minute parts is done by the Laser thereby reducing the Phaco energy and time making it safer and less traumatic for the eye.

What are the steps in Femtocataract surgery procedure?

After pupillary dilatation and topical anesthesia the applanation (flattening of the cornea) with disposable patient interface cone is done.

  • Real time OCT (Optical coherence tomography) along with high resolution video microscope captures images of the anterior segment of your eye which are further analysed.
  • Every step is planned and customized according to your eye requirement to enhance vision. After mapping and marking of the size, shape and location of the incisions and surgery is completed with the removal of the capsulorhexis flap, the lens fragmentation and cortical clean up.
  • Finally the IOL is implanted.

WHY Femtocataract surgery?

  • Less complications- In comparison with phacoemulsification certain risks of injury to the capsule, iris, and cornea.
  • Laser Precision and Accuracy
  • Decreased Phaco energy
  • Better refractive outcome– you can now experience functional visual improvement and spectacle independence
  • Safer surgery- The laser wavelength is not absorbed by the corneal tissue.
  • Moreover least risk of infections.
  • Perfect capsulotomy- Accurate capsulotomies improves the precision of intraocular lenses (IOL)
  • Helps to treat astigmatism, complex cataract cases, dense lenses etc.

The challenges

  • May not be suitable to every patient.
  • Cost and Infrastructure- The challenge of a huge financial investment both in initial cost and maintenance costs for the surgeon and procedure cost for the patient.
  • Medical insurance – not covered by insurance.

Laser Systems used in Femtosecond cataract surgery

          • VisuMax from Zeiss
          • LenSx from Alcon
          • Catalys from Optimedica
          • LensAR fom LensAR
          • Technolas

Other systems (Femto LDV Z6 –FDA cleared, Centurion newly released)

Femtocataract surgery is being adopted worldwide successfully nevertheless the technology is relatively new compared with conventional phacoemulsification cataract surgery. It has been used in complicated cataract cases too. The outcome on a large scale human trials and studies would need more time to justify.

Your eye is precious.

No doubt the best treatment suggested for you will be the one which you are best suited and which will optimise the best overall outcome.

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