Eyeworld

EW FEATURE 56 Highlights from ESCRS 2016 • December 2016 During the ESCRS paper session, Dr. Sauder was asked, if the tech- nology has been around for awhile, why it "hasn't made big waves?" "Is that just conservatism or is there another explanation on your part?" an attendee from the audi- ence asked. "I don't know—maybe I didn't do many waves or enough waves," Dr. Sauder responded. "I can only speak for me and my clinic, and in our clinic, it has made big waves. I've been [using] this technology since 2001," he said, adding that it was 4 years ago when he decided he could start offering the technology to premium cataract surgery pa- tients. Dr. Vryghem expects interest in the technology to increase once it is available for commercial use. "The tool has been limited to some selected European centers, and it is not available for commercial use until 2017," he said. "We want to build up experience so that once it is launched and open to the market, we can give good advice about how to handle the tool and avoid the capsule ruptures I had, for example. We want to build up more data on the real advantages of nanosecond laser cataract surgery." EW Nanosecond continued from page 55 Perspective from an early adopter A. John Kanellopoulos, MD, clinical professor of ophthalmology, New York University School of Medicine, New York, and medical director, LaserVision Clinical and Research Eye Institute, Athens, Greece, was first introduced to nanosecond laser cataract surgery in 1997 when it was then known as the Dodick Photolysis System (A.R.C. Laser), a system that used Nd:YAG laser light energy. Dr. Kanellopoulos was involved in the first clinical trials of the technology to receive the CE mark in the European Union and later approval from the U.S. Food and Drug Administration in the early 2000s. Now, Dr. Kanellopoulos said he regularly performs nanosecond laser cataract surgery. With the evolution of the device—the Cetus uses single-use probes with advanced ergonomics and laser delivery—nanosecond laser cataract surgery is actually his preference for softer cataracts or for patients with significant posterior subcapsular cataracts, ranging 1–2 on a 1–4 scale of nuclear sclerosis. "I would strongly recommend a surgeon who has access to this technology to use it, under the appropriate tutorage, as I think a significant percentage of surgeons would be surprised with some of the intrinsic advantages of [it]," Dr. Kanellopoulos said. "Its ability to remove cataracts without any energy in the form of heat delivered into the cornea or the anterior chamber; its use of a small fraction of energy compared to even the best phacoemulsification devices available globally today; with regard to softer lenses, its ability of better purchase of the soft cataract material; and its better surgical outcome in a patient where a complicated cataract procedure matters the most. "I think the future will determine whether this procedure will be a significant alternative to phacoemulsification and/or FLACS in the global cataract surgery armamentarium," he added. Editors' note: Dr. Kanellopoulos has no financial interests related to his comments. Contact information Kanellopoulos: ajk@brilliantvision.com References 1. Tanev I, et al. Nanosecond laser-assisted cataract surgery: Endothelial cell study. J Cataract Refract Surg. 2016;42:725–30. 2. Mastropasqua L, et al. All laser cataract surgery compared to femtosecond laser phacoemulsification surgery: corneal trauma. Int Ophthalmol. 2016. [Epub ahead of print] Editors' note: Drs. Vryghem and Tanev have no financial interests related to their comments. Contact information Tanev: itanev@skycode.com Vryghem: jerome.vryghem@skynet.be

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