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Refractive Surgery | Sep 2010

Femtosecond Cataract Surgery With the OptiMedica Platform

Femtosecond laser cataract surgery is compelling in its ability to provide a uniform outcome.

OptiMedica Corp. (Santa Clara, California) has recently developed a femtosecond laser platform that enables ophthalmologists to perform laser cataract surgery. In the evolving market for premium IOL surgery, this technology is designed to deliver a more accurate, metered, and consistent approach to cataract surgery to optimize the utility and performance of new-technology IOLs.

My colleagues and I are participating in an ongoing clinical trial at Centro Laser in Santo Domingo, Dominican Republic, using OptiMedica Corp.'s femtosecond laser platform. I hope this technology will be available for my patients in the very near future.

OptiMedica Corp.'s integrated optical coherence tomography (OCT) system maps the anterior segment. It measures the pupil size, the anterior chamber depth, the lens thickness, and the position of the anterior lens capsule immediately prior to laser surgery. The treatment software subsequently optimizes pattern parameters, such as the diameter and depth of lens fragmentation in real time.

FLEXIBLE SURGERY WITH LASER PRECISION
A number of cutting patterns are available. The system today performs several corneal incisions, which can be used as primary cataract incisions, paracenteses, and relaxing incisions. With OCT-guided accurate placement, the platform delivers capsulotomies of any size and shape that the surgeon requires. These are features that one would expect on a platform like this and that expand its clinical utility.

OptiMedica Corp.'s femtosecond laser system provides effective options for lens fragmentation, with patterns chosen based on the clinical examination, nuclear density, and OCT data. The treatment facilitates the removal of the nucleus and minimizes the required amount of phaco energy. In some cases, the laser treatment can eliminate phacoemulsification from the process.

CONSISTENT OUTCOMES
The OptiMedica platform allows the surgeon to optimize the primary cataract incision as well as the paracentesis so that they are reproducible with predictable results. Consistency of the capsulotomy is a key factor for ensuring optimal premium IOL implantation and for achieving targeted refractive endpoints. Exact placement of the lens is becoming increasingly important for accommodating lenses that require some optical-mechanical engagement of the ciliary body-capsular bag complex with a consistent (or at least reproducible and predictable) movement and noncircular capsulotomies. No surgeon believes he can create a capsulotomy freehand as precisely and reproducibly as the laser can.

In femtosecond cataract surgery, combining integrated OCT with flexible cutting patterns and laser precision contributes to a consistent outcome. This is why I find femtosecond cataract surgery using the platform from OptiMedica Corp. appealing.

John A. Vukich, MD, is a partner at the Davis Duehr Dean Center for Refractive Surgery, Madison, Wisconsin. He states that he is a consultant to and investigator for OptiMedica Corp. Dr. Vukich may be reached at tel: +1 608 282 2000; e-mail: javukich@facstaff. wisc.edu.

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