Femtosecond Laser Cataract Surgery: Practice-Changing Yet?

Mark H. Blecher, MD; Richard Tipperman, MD; Sydney L. Tyson, MD, MPH; Mark F. Pyfer, MD; Robert S. Bailey, MD


October 21, 2013

Editorial Collaboration

Medscape &

This feature requires the newest version of Flash. You can download it here.
In This Article

Who Gets Femtocataract Surgery?

Mark H. Blecher, MD: Thank you for joining us for a panel discussion on femtosecond laser-assisted cataract surgery. I am Dr. Mark Blecher, Co-Director of Cataract and Primary Eye Care here at Wills Eye Hospital, and I am joined by several of my colleagues on the cataract service.

Femtosecond lasers have been available for cataract surgery for more than a year in both Wills and the Wills Surgical Network. I would like to find out from our panelists how this has changed their practice and their discussions with cataract surgery patients.

Dr. Tipperman, you have had the most experience with femtosecond laser-assisted cataract surgery. How has this changed how you approach the preoperative discussion with cataract patients?

Richard Tipperman, MD: It has been an evolution, and that is what we have seen across the country. When this technology was first released, the main indications were patients with advanced technology lenses; that is still one of the key categories, but the femtosecond laser technology lets us treat astigmatism as well. The more you use it, the more you realize that in a total cataract practice for what I would consider high-risk patients -- those with pseudoexfoliation, dense lenses, and shallow chambers -- this technology benefits those patients as well, so that over time you begin to be comfortable that it has its significant advantages for almost every patient having cataract surgery.

Dr. Blecher: Dr. Tyson, you haven't adopted this technology yet. How has the fact that this technology is available affected how you approach cataract surgery?

Sydney L. Tyson, MD, MPH: This technology is the future, and it will eventually be the standard of care, but for me and my practice now, I don't see adopting the technology for the clinical benefit that my patients will receive and the costs associated with it, which are going to be substantial.

Dr. Blecher: Dr. Pyfer, who do you offer this to?

Mark F. Pyfer, MD: I offer this to anyone who is getting a premium lens, a multifocal lens, or an accommodating lens, especially if they have astigmatism that is amenable to correction with the femtosecond laser. We are at a stage with this technology that is similar to where we were with phacoemulsification before foldable lenses were available. We are poised at the brink of a revolution in what we can do with a femtosecond laser -- the accuracy, the predictability, being able to soften the lens -- and we are waiting for the lens technology to catch up. So, essentially, I offer it to anybody who would be a candidate. In fact, I am working on ways that I can offer it to everyone in my practice.