John S Jarstad
University of Missouri, USA
Title: Pearls from 1000 robotic femtosecond bladeless laser-assisted cataract procedures
Biography
Biography: John S Jarstad
Abstract
Statement of the Problem: Robotic Femtosecond Bladeless Laser Cataract Surgery is the newest and most controversial procedure in the world’s most common surgical procedure cataract surgery with intraocular lens implantation. First performed in England in 1949 by Sir Harold Ridley, the technology for both removing the cataractous lens and implanting a corrective intraocular replacement lens has reached new heights of precision and success with the introduction of the femtosecond laser, approved by the FDA for use in patients (2011). The purpose of this study is to describe the experience of one surgeon who has performed over 1000 robotic femtosecond bladeless laser-assisted cataract procedures and review common pearls that have led to excellent outcomes.
Methodology & Theoretical Orientation: 1000 patient procedures were reviewed to determine common complications and findings that would improve outcomes compared to early Femtosecond Laser-assisted Cataract Surgeries (FLACS).
Findings: Common complications included: difficulty docking the laser on Asian patients and those with small eyelid fissures, incomplete anterior capsulotomy with early interface attachments, posterior capsule blow-out, decentered Lens capsulotomy and small pupil and Floppy Iris Syndrome.
Conclusion & Significance: Whilst some conservative ophthalmologists have criticized Femtosecond Laser-assisted Cataract Surgery (FLACS) as an overhyped gimmick, its usefulness in patients with dense, mature and hyper- mature (Morgagnian) cataracts and in assuring the accurate centration of newer multi-focal intraocular lens implants is unquestioned in the authors opinion. Robotic Femtosecond Bladeless Laser-assisted Cataract Surgery is here to stay and will be the future of the most common surgical procedure performed throughout the world.