Laser-Assisted Cataract Surgery

Benefits and Barriers

Kathryn M. Hatch; Jonathan H. Talamo


Curr Opin Ophthalmol. 2014;25(1):54-61. 

In This Article

Abstract and Introduction


Purpose of review The use of the femtosecond laser (FSL) in cataract surgery may represent the largest advancement in the field since the inception of phacoemulsification. The goal of this review is to outline the benefits of and barriers to this technology.
Recent findings There are several significant potential benefits of the FSL in cataract surgery over conventional manual cataract surgery: precise capsulotomy formation, clear corneal and limbal relaxing incision construction, lens fragmentation, and lens softening. Evidence suggests that refractive benefits include more precise effective lens position as well as reduced effective phacoemulsification time with the use of FSL compared with manual surgery. Patients with conditions such as Fuchs' endothelial dystrophy, pseudoexfoliation, history of trauma, or brunescent cataracts may particularly benefit from this technology. There are significant financial and logistical issues to consider prior to the purchase of a FSL, including the cost of the laser, and charges to patients, and how the laser affects the patient flow in the operating room.
Summary The FSL may significantly change the current approach to cataract surgery.


The use of the femtosecond laser (FSL) in cataract surgery may prove to be one of the biggest changes in the fields of cataract and refractive surgery in the last several decades. Commonly referred to as ReLACS, refractive laser-assisted cataract surgery has generated considerable controversy among advocates and skeptics. Advocates of the technology emphasize the laser's precision and claim that it provides superior outcomes with higher safety profiles and will allow for many future applications in the field. Skeptics point out the high costs and potential inconveniences associated with its use, and claim that the same results may be achieved with manual conventional surgery.[1]