EW CATARACT
25
July 2015
also took video, but not as well as a
video camera does. And a lot of vid-
eo cameras take pictures, but not as
well as a camera can," he said. "Just
because it can do it doesn't mean
it does it better, and the lasers that
are just designed to do LASIK flaps
probably still do them better than
the femto cataract lasers."
People who are critical of the
femto for cataract technology are
probably not as concerned about the
flap-making aspects as much as the
capsulotomy, Dr. Weikert said.
"We've seen the devices im-
prove the speed of the capsulotomy,
and the faster the laser is, the less
chance for patient movement," he
said. "If the patient moves during
the capsulotomy, even on platforms
where it may only take 1–2 seconds,
surgeons may end up with areas that
are suboptimally treated."
Down the road
Dr. Weikert is hopeful the scanning
technology improves, "so we can do
quantitative measures of the anteri-
or segment in real time" in a more
integrated setup.
"We're almost at real-time scan-
ning, and I'm looking forward to the
devices incorporating that ability
more," Dr. Weikert said.
He'd also like to see manufac-
turers improve the geometry of the
incisions a bit more.
"Right now, we're limited
on the angle you can make your
paracentesis and the length, and it's
sometimes more difficult to identify
the limbus," he said.
Dr. Gira said the wounds the
laser creates are not as good as the
ones he manually creates with a
diamond blade.
"The wound architecture is
important when you're doing the
procedure itself, and the wound is
a lot better with a diamond knife
than with a laser-created wound,"
he said. "I think it's more restrictive
when you're doing cataract surgery
through a laser-created wound. A
wound that's been created by a laser
is just not as smooth, not as com-
fortable to work with."
Dr. Gira said he's looking for-
ward to additional improvements
in how to soften the nucleus. "The
manufacturers are looking at differ-
ent ways to speed that part of the
process and make it more efficient
by using less energy," he said. "In
the next few months, we're going to
see this technology get better, faster,
and less expensive." EW
Editors' note: The physicians have
no financial interests related to their
comments.
Contact information
Black: daniel.black@suneye.com.au
Gira: joegira@gmail.com
Weikert: mweikert@bcm.tmc.edu
