Article

Initial clinical evaluation of an intraocular femtosecond laser in cataract surgery.

1st Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
Journal of refractive surgery (Thorofare, N.J.: 1995) (Impact Factor: 2.78). 12/2009; 25(12):1053-60. DOI: 10.3928/1081597X-20091117-04
Source: PubMed

ABSTRACT To evaluate femtosecond laser lens fragmentation and anterior capsulotomy in cataract surgery.
Anterior capsulotomy and phacofragmentation procedures performed with an intraocular femtosecond laser (LenSx Lasers Inc) were initially evaluated in ex vivo porcine eyes. These procedures were then performed in an initial series of nine patients undergoing cataract surgery. In addition to standard intraoperative assessments (including capsulotomy diameter accuracy and reproducibility), optical coherence tomography was used to evaluate human procedures.
For an intended 5-mm capsulorrhexis in porcine eyes, average achieved diameters were 5.88+/-0.73 mm using a standard manual technique and 5.02+/-0.04 mm using the femtosecond laser. Scanning electron microscopy revealed equally smooth cut edges of the capsulotomy with the femtosecond laser and manual technique. Compared to control porcine eyes, femtosecond laser phacofragmentation resulted in a 43% reduction in phacoemulsification power and a 51% decrease in phacoemulsification time. In a small series of human clinical procedures, femtosecond laser capsulotomies and phacofragmentation demonstrated similarly high levels of accuracy and effectiveness, with no operative complications.
Initial results with an intraocular femtosecond laser demonstrate higher precision of capsulorrhexis and reduced phacoemulsification power in porcine and human eyes.

1 Follower
 · 
168 Views
  • Source
    • "A number of other ophthalmological applications of ultrafast laser surgery are either being developed or are in the early stages of clinical acceptance. These applications include the use of ultrafast lasers to: 1) replace continuous curvilinear capsulorhexis during cataract surgery [63]–[66] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Ultrafast pulsed lasers can be used to achieve remarkable precision during surgical ablation. Through nonlinear interactions with tissue, ultrafast lasers can provide a largely non-thermal mechanism of ablation and a unique ability to create targeted damage within bulk tissue. These advantages have made ultrafast lasers the ideal surgical tool for various novel applications in ophthalmology. Clinical adoption of ultrafast lasers in other surgical applications remains limited in part due to the lack of a means for fiber delivery of ultrafast laser pulses as a flexible, hand-held surgical endoscope. This review provides an overview of the recent advances in bringing this unique surgical tool into the clinic. We discuss fundamental mechanisms and limitations of ultrafast laser ablation, novel techniques for overcoming these limitations, the current state of clinical applications, and conclude with our recent efforts in developing fiber-coupled probes for flexible ultrafast laser surgery and imaging.
    IEEE Journal of Selected Topics in Quantum Electronics 12/2013; 20(2):1-14. DOI:10.1109/JSTQE.2013.2287098 · 3.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We present a high-speed photographic analysis of the interaction of cavitation bubbles generated in two spatially separated regions by femtosecond laser-induced optical breakdown in water. Depending on the relative energies of the femtosecond laser pulses and their spatial separation, different kinds of interactions, such as a flattening and deformation of the bubbles, asymmetric water flows, and jet formation were observed. The results presented have a strong impact on understanding and optimizing the cutting effect of modern femtosecond lasers with high repetition rates (>1 MHz).
    Journal of Biomedical Optics 01/2010; 15(6):068003. DOI:10.1117/1.3526366 · 2.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The human eye is a favored target for laser surgery due to its accessibility via the optically transparent ocular tissue. Femtosecond lasers with confined tissue effects and minimized collateral tissue damage are primary candidates for high precision intraocular surgery. The advent of compact diode-pumped femtosecond lasers, coupled with computer controlled beam delivery devices, enabled the development of high precision femtosecond laser for ophthalmic surgery. In this article, anterior segment femtosecond laser applications currently in clinical practice and investigation are reviewed. Corneal procedures evolved first and remain dominant due to easy targeting referenced from a contact surface, such as applanation lenses placed on the eye. Adding a high precision imaging technique, such as optical coherence tomography (OCT), can enable accurate targeting of tissue beyond the cornea, such as the crystalline lens. Initial clinical results of femtosecond laser cataract surgery are discussed in detail in the latter portion part of the article.
    Proceedings of SPIE - The International Society for Optical Engineering 02/2010; DOI:10.1117/12.847895 · 0.20 Impact Factor

Preview

Download
5 Downloads
Available from