Chicago,
Illinois, May 24, 2010 - The femtosecond laser has helped decrease the
complications of making a LASIK flap, and now several companies are
using this technology to bring added safety to cataract surgery.
Cataract extraction is the most common surgical procedure performed
in the United States, and new technology has made it much more
successful than it was just a generation ago. The femtosecond laser can
perform several parts of the surgery with great precision.
The U.S. Food and Drug Administration has already approved the
femtosecond laser offered by LenSx Lasers, Inc. for two parts of
cataract surgery: (a) making the openings in the eye through the cornea;
and (b) making the opening in the lens called a capsulotomy. Potential
uses of the femtolaser would be in breaking up the lens itself and in
reducing astigmatism.
Greater Speed and Precision
Dr. Mark Golden
[http://www.doctorsforvisualfreedom.com/index.php?option=com_content&view=article&id=46&Itemid=60],
a well known Chicago LASIK surgeon experienced with several femtosecond
platforms, says, "The great beauty of the femtosecond laser is its
incredible precision. It will soon be possible to take a picture of a
patient's eye, plan cataract surgery on the computer, and engage the
laser to the eye to perform much of the surgery."
He goes on, "This will allow for a higher level of precision in the
ability to implant premium intraocular lenses, and it will decrease the
need for spectacles postoperatively because of its ability to eliminate
corneal astigmatism. Additionally, it will help us with the most
difficult cataract procedures as we will be able to remove hard lenses
from the eye with much less trauma."
Dr. Golden goes on to say, "Anything that can be done to decrease
surgical time in the eye itself has to be of benefit, as more time in
the eye directly correlates with the potential for more iatrogenic
damage (caused by physician activity)."
Uncertainty as to Medicare
In addition to LenSx, both LensAR and OptiMedica have femtosecond
platforms in clinical testing. Besides the cost of these systems, the
biggest problem will be the added time needed to set the patient up to
the laser and then to the operating table. That could increase the cost
of surgery in these days of declining reimbursement despite increased
need for
cataract surgery as the population ages.
More than a million cataract surgeries are already performed in the
United States each year. If the cost of each surgery were to increase by
only a few hundred dollars, this could add up to an enormous drain on
our already strained Medicare budget.
Considering the great success of cataract surgery as it is now
performed, the question remains as to whether the femtosecond laser will
be used as a new cataract surgery tool. It promises even greater vision
surgery success with increased safety, but we must wait and see how the
future of laser eye surgery develops.