COMMENTARY

Femtosecond Laser: Why We Need It for Cataract Surgery

American Academy of Ophthalmology 2013

Roger F. Steinert, MD; H. Burkhard Dick, MD, PhD

Disclosures

November 22, 2013

In This Article

No Capsular Block Syndrome

Dr. Steinert: Another thing that has been said at meetings about femto is that cortical cleanup is more difficult because the little tags of anterior cortex that you want to grab are not there. Have you experienced that?

Dr. Dick: No, not at all. We are doing the hydrodissection and hydrodelineation the same as we used to. I am convinced that the so-called "capsular block syndrome" that was described with another platform is not possible with the OptiMedica system. The reason is that you have a totally different fragmentation; we fired into the lenses of 14 eyes in a prospective clinical trial (with ethics committee permission) and we didn't do the capsulotomy at all. Of interest, nothing happened -- no capsular tears, or what you might think would happen as a result of blowing up the lens. We were excessively firing into the lens.

I'm convinced that this cannot happen, and it has not been reported by users worldwide, nor by me. I'm convinced that this is something different. Hydrodissection and -delineation are done the way you are used to. We did a trial comparing coaxial standard cataract surgery with femto and monoaxial as well as biaxial surgery, and we didn't find a difference in terms of ease of aspiration, time for aspiration, and so forth. So, there may be differences between the platforms.

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