Eyeworld

75 EW SECONDARY FEATURE February 2015 Editors' note: Dr. Epitropoulos has financial interests with Bausch + Lomb (Bridgewater, N.J.). Dr. Shamie has no financial interests related to her comments. The sub-incisional cortical removal tends to be more challeng- ing than traditional cataract surgery because the laser cuts the cortical fi- bers flush to the edge of the capsule, so Dr. Shamie urges practitioners to consider bimanual surgery, which she finds helpful in these cases. Dr. Epitropoulos said one complication that may occur with the femtosecond laser is computer system failure. "For this reason sur- geons have to be prepared to revert to traditional phacoemulsification, and the consent form should reflect this," Dr. Epitropoulos said. "This issue, however, is becoming less of a problem with improving software." When it comes to making clear corneal or side-port incisions, there has been some criticism of the qual- ity of these with the femtosecond laser. "I think that the technology is still evolving with some platforms more than others," Dr. Epitropoulos said. She finds that in some cases she has to work to get the incision open because there are some adhesions. In other cases, the incisions are perfect. "Additional studies are needed to determine whether femtosecond laser corneal incisions are superior to standard temporal clear corneal incisions." Miosis from the laser energy is another femtosecond laser compli- cation. "This is very frustrating to the surgeon because usually once the pupil comes down, you can't do anything to bring it back up com- pletely like it was," Dr. Epitropoulos said. "This makes what should be a straightforward cataract treatment more difficult, with higher risks of complication." "Using a nonsteroidal drop prior to cataract surgery is essential in these cases to counteract the prostaglandin release as a result of the femtosecond treatment," Dr. Epitropoulos said. Despite unique complications, Dr. Shamie said that femtosecond technology is here to stay. "Patients are asking for it, and the precision that it offers is exciting in that you can perform cataract surgery in very dense cataracts with little collateral damage to the cornea," Dr. Shamie said. "It minimizes the risk of creating capsulotomies in not only routine cases but also challenging cases." EW Finding the right angle can be challenging ! Finding the correct orientation of a Toric IOL implant is not an easy task ! The OCULUS Pentacam ® can help: 9 Topography of anterior and posterior corneal surface 9 Total corneal refractive power 9 Evaluation of corneal optical densitometry 9 Support for selection, orientation and calculation of Toric IOLs Visit the OCULUS Booth #1845 at the ASCRS 2015 in San Diego www.oculususa.com Email: ads@oculususa.com • Tel: 888-519-5375 Sign up for the Pentacam ® educational events at www.pentacamseminar.com Contact information Epitropoulos: aepitrop@columbus.rr.com Shamie: nshamie@yahoo.com

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