1 / 29

AAO Media Briefing Laser Assisted Cataract Surgery October 25, 2009 San Francisco, CA

AAO Media Briefing Laser Assisted Cataract Surgery October 25, 2009 San Francisco, CA William W. Culbertson, MD Professor of Ophthalmology Bascom Palmer Eye Institute – Miami, Florida Interests: Cataract and Refractive Surgery (LASIK) Financial Relationships:

libitha
Download Presentation

AAO Media Briefing Laser Assisted Cataract Surgery October 25, 2009 San Francisco, CA

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. AAO Media BriefingLaser Assisted Cataract SurgeryOctober 25, 2009San Francisco, CA

  2. William W. Culbertson, MD • Professor of Ophthalmology • Bascom Palmer Eye Institute – Miami, Florida • Interests: Cataract and Refractive Surgery (LASIK) • Financial Relationships: - Optimedica (Santa Clara, CA): Consultant - Abbott Medical Optics (Santa Ana, CA): Consultant - Carl ZeissMeditec (Dublin, CA): Consultant - Alcon (Fort Worth, TX): Speaker

  3. Contemporary Cataract Surgery Steps: • Incision • Capsulorhexis • Phacoemulsification • IOL Insertion • Relaxing Incisions (Astigmatism) Eyemaginations Cartoon of Cataract surgery 1 Minute (runs with video below) Video of Cataract Surgery 1.0 minute

  4. Potential Problems in Contemporary Cataract Surgery: Steps: Incision Capsulorhexis Phacoemulsification IOL Centration Relaxing Incisions (Astigmatism) Leaking wound and endophthalmitis

  5. Potential Problems in Contemporary Cataract Surgery: Steps: Incision Capsulorhexis Phacoemulsification IOL Centration Relaxing Incisions (Astigmatism)

  6. Potential Problems in Contemporary Cataract Surgery: Steps: Incision Capsulorhexis Phacoemulsification IOL Centration Relaxing Incisions (Astigmatism) Corneal Phaco Burn Phaco burn picture

  7. Potential Problems in Contemporary Cataract Surgery: Steps: Incision Capsulorhexis Phacoemulsification IOL Centration Relaxing Incisions (Astigmatism) Decentered Multifocal IOL Decentered IOL

  8. Potential Problems in Contemporary Cataract Surgery: Steps: Incision Capsulorhexis Phacoemulsification IOL Centration Relaxing Incisions (Astigmatism) Decentered Multifocal IOL Decentered IOL

  9. Potential Problems in Contemporary Cataract Surgery: Pre-op LRIs Steps: Incision Capsulorhexis Phacoemulsification IOL Centration Relaxing Incisions (Astigmatism) Post-op LRIs

  10. Relaxing Incision for Astigmatism:

  11. History of “Laser Cataract Surgery” • YAG laser lens softening • Dodick laser • Phoenix Laser

  12. Femtosecond Laser in Ophthalmology • Corneal Surgery Lasik flaps Corneal transplants (Corneal relaxing incisions) (Cataract surgery incisions) • Companies doing corneal surgery with fs laser: AMO (Intralase) Technolas (FEMTEC Perfect Vision) Zeimer (LDV) Zeiss (Visumax)

  13. Femtosecond Laser Photodisruption • Plasma expansion • Shock wave pressure • Cavitation bubble creation • Decreased pulse duration reduces photodisruption threshold and secondary effects allowing closer placement of pulses Initial Beam Cavitation Bubble

  14. Femtosecond Laser-Assisted Cataract Surgery (FLACS) Three American Companies: LensAR (Winter Park, FL) LenSx (Aliso Viejo, CA) Optimedica (Santa Clara, CA)

  15. Femtosecond Laser-Assisted Cataract Surgery (FLACS) Objectives: • Increase safety • Improve precision • Automate undependable components

  16. Femtosecond Laser-Assisted Cataract Surgery (FLACS) Laser Assisted Steps: • Imaging of the front of the eye • Cataract incision • Capsulorhexis (anterior capsulotomy) • Cataract (lens nucleus) segmentation and softening • Limbal relaxing incisions

  17. FS Laser-assisted Cataract SurgeryImaging and Registration: OCT Technique (Optimedica) Scheimpflug Technique (LensAR)

  18. Cataract Incision: (Optimedica)

  19. FS Laser-assisted Cataract Surgery:Cataract Incision: (Optimedica)

  20. FS Laser-Assisted Cataract Surgery:Cataract Incision: Cartoon of incision Video of incision

  21. Capsulorhexis: (Optimedica)

  22. Capsulorhexis: (LensAR)

  23. Capsulorhexis Edge: SEM 500X 50X

  24. Nuclear Softening/Segmentation: (LensAR) (LenSx)

  25. Nuclear Softening/Segmentation: (Optimedica)

  26. Limbal Relaxing Incisions:

  27. FS Laser-assisted Cataract Surgery:Advantagesand Disadvantages: • Advantages: • Improved safety • Increased precision • Enhanced reproducibility • Disadvantages: • Increased Cost • Added time

  28. Conclusion: Femtosecond laser assisted cataract surgery is a promising improvement on standard contemporary phacoemulsification cataract surgery.

  29. FS Laser-Assisted Cataract Surgery:The Future: • Sub Bowman’s Relaxing Incisions • Complex Cataract Incisions • Customized Capsulorhexis • Capsulorhexis Integrating with IOLs - “Capsule in the Lens” - Toric IOL Orientation • Lens Refilling Surgery

More Related