Eyeworld

EW CATARACT 32 But Dr. Packard wondered about the future of the femtosecond laser in cataract and refractive lens exchange surgery. Those who make the claim that the femtosecond laser is the next step in cataract surgery make an implication that Dr. Packard chooses to interrogate critically: Will it be an improvement in our current cataract procedure? More to the point: Will our procedure be worse without it? Dr. Packard cited data from studies that call into question some of the presumed advantages of the femtosecond laser over microker- atomes. For instance, while the capsulorhexis may be more accu- rate with femtosecond lasers, there are studies that show no or at least clinically insignificant correlation between shape and position with re- fractive outcome. Meanwhile, there are studies that show a significantly greater risk of anterior capsule tears with lasers, which create "micro can opener" rather than smooth incision edges. According to Dr. Packard, the current data confirms that there is no real need for the femtosecond la- ser in terms of creating the incision, the capsulorhexis, or even speed; in terms of visual outcomes, femtosec- ond lasers provide only marginally better results that are not clinically significant. Physicians discuss hot topics in the subspecialty at spring meeting E xperts voiced differing views on "Controversies in Cataract Surgery" in a symposium at the 30th Asia-Pacific Academy of Ophthalmology (APAO) Congress in conjunction with the 20th Chinese Ophthalmological Society Congress, Guangzhou, China. Richard Packard, MD, London, began with a particularly conten- tious topic—and perhaps an even more contentious perspective. In his talk, Dr. Packard launched on a comprehensive takedown of femto- second laser cataract surgery. In the last 47 years since Charles Kelman performed the first phacoemulsification on a blind eye, the procedure and the technology has evolved to incorporate features such as microincisions, using devices that have power modulation and exquisite control of fluidics to make the procedure easier, safer, with a low risk of posterior capsular opaci- fication. Meanwhile, femtosecond lasers have only been around in the last decade or so, during which time they have shown utility in a number of different ophthalmic applications. by Chiles Samaniego EyeWorld Asia-Pacific Senior Staff Writer Experts discuss controversies in cataract surgery Dr. Tassignon discusses the treatment of floaters in a presentation at the 30th APAO Congress in Guangzhou, China. Source: ASCRS

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