COMPLEX CATARACT SURGERY AND THE ROLE OF FEMTOSECOND LASER
FINANCIAL DISCLOSURES
CASE PRESENTATION 63 YO WM
CAPSULAR TENSION RINGS Ahmed, Iqbal Ike K., et al. "Optimal timing of capsular tension ring implantation: Miyake-Apple video analysis. Journal of Cataract & Refractive Surgery 31.9 (2005): 1809-1813. Leger U, Witschel BM, Lim SJ, et al. The capsular a new device for complicated cataract surgery. Presented at the third American-International Congress on Cataract, IOL and Refractive Surgery. Seattle, Washington, May 11, 1993
CAPSULAR TENSION RING ENTANGLEMENT IATROGENIC ZONULAR DAMAGE Page, TP. "Suture-guided capsular tension ring insertion to reduce risk for iatrogenic zonular damage." Journal of Cataract & Refractive Surgery41.8 (2015): 1564-1567.
CTR COMPLICATIONS AND TECHNIQUES TO AVOID THEM Rixen, Jordan J., and Thomas A. Oetting. "Fishtail on a line technique for capsular tension ring insertion. Journal of Cataract & Refractive Surgery 40.7 (2014): 1068-1070. Blecher, Mark H., and Matthew R. Kirk. "Surgical strategies for the management of zonular compromise. Current opinion in ophthalmology 19.1 (2008): 31-35.
SUTURE GUIDED CTR PLACEMENT Page, TP. "Suture-guided capsular tension ring insertion to reduce risk for iatrogenic zonular damage." Journal of Cataract & Refractive Surgery41.8 (2015): 1564-1567.
Page, TP. "Suture-guided capsular tension ring insertion to reduce risk for iatrogenic zonular damage." Journal of Cataract & Refractive Surgery41.8 (2015): 1564-1567. SGCTR
POSTERIOR POLAR CATARACT 26% POSTERIOR CAPSULAR RUPTURE RATE Osher, Robert H., Bernard C-Y. Yu, and Douglas D. Koch. "Posterior polar cataracts: a predisposition to intraoperative posterior capsular rupture." Journal of Cataract & Refractive Surgery 16.2 (1990): 157-162.
POSTERIOR POLAR CATARACT 26% Tear-drop sign of posterior capsule dehiscence on Scheimpflug imaging R Arora, S Mehta, J L Goyal, S Jain and D Gupta Eye (2010) 24, 737 738
POSTERIOR POLAR CATARACT
TORIC IOL USE WITH CAUTION
POSTERIOR POLAR TORIC
POD # 1 UCVA 20/25
POST OCCLUSION SURGE
Pressure POST OCCLUSION SURGE Pressure R1 Ch1 200mV M 1.00s A Ch1 1.78V Time Data on file; Bausch & Lomb Incorporated.
POST OCCLUSION SURGE
STEPS TO AVOID POST OCCLUSION SURGE FACTORS CONTROLLED BY THE MANUFACTURER FACTORS CONTROLLED BY THE SURGEON
POST OCCLUSION SURGE OPEN CAPSULE CRYSTALENS
LENS AND CATARACT BASIC CLINICAL SCIENCE COURSE CHAPTER 1-3
CERULEAN CATARACT
PROGRESSIVE CERULEAN CATARACT SECOND EYE PLANNED TORIC EDOF
POST OP
FEMTOSECOND LASER CATARACT SURGERY INVALUABLE OR IN-VOGUE?
SURGICAL OUTCOMES AND SAFETY OF FEMTOSECOND LASER CATARACT SURGERY Roberts, T, et al. "Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases."ophthalmology 120.2 (2013): 227-233.
RESULTS (P<0.001 FOR ALL COMPARISONS) Roberts, T, et al. "Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases."ophthalmology 120.2 (2013): 227-233.
EARLY EXPERIENCE WITH THE FEMTOSECOND LASER FOR CATARACT SURGERY Bali, S et al. "Early experience with the femtosecond laser for cataract surgery." Ophthalmology 119.5 (2012): 891-899.
CONCLUSIONS Bali, Shveta Jindal, et al. "Early experience with the femtosecond laser for cataract surgery." Ophthalmology 119.5 (2012): 891-899.
META ANALYSIS OF THE LITERATURE 2016
COMPARISON OF VITREOUS LOSS RATES BETWEEN MANUAL PHACOEMULSIFICATION AND FEMTOSECOND LASER ASSISTED CATARACT SURGERY
FEMTO SHOWS ADVANTAGES OVER MANUAL FOR DENSE CATARACTS- JCRS 2017
ADVANTAGES OF FLACS 1. Dick HB, Pena-Aceves A, Manns A, Krummenauer F. New technology for sizing the continuous curvilinear capsulorhexis: prospective trial. J Cataract Refract Surg. 2008;34(7):1136-1144. 2. 2. Tan JC. Capsulotomy. Curr Opin Ophthalmol. 2001;12(1):82-85. 3. 3. Ravalico G, Tognetto D, Palomba M, Busatto P, Baccara F. Capsulorhexis size and posterior capsule opacifi cation. J Cataract Refract Surg. 1996;22(1):98-103. 4. 4. Aykan U, Bilge AH, Karadayi K. The effect of capsulorhexis size on development of posterior capsule opacifi cation: small (4.5 to 5.0 mm) versus large (6.0 to 7.0 mm). Eur J Ophthalmol. 2003;13(6):541-545. 5. 5. Hollick EJ, Spalton DJ, Meacock WR. The effect of capsulorhexis size on posterior capsular opacifi cation: one-year results of a randomized prospective trial. Am J Ophthalmol. 1999;128(3):271-279.
PCRLI S (LRI S) Donnenfeld, E., A. Barsam. "LenSx: Femtosecond Laser Relaxing Incisions." Femtolaser Cataract Surgery (2014): 77.
FLACS LRI
FLACS LRI POST OP DAY 7
PERFORATED AK INCISION
CASE PRESENTATION
FEMTOSECOND LASER CATARACT SURGERY IN THE INTUMESCENT CATARACT Conrad-Hengerer, Ina, et al. "Femtosecond laser assisted cataract surgery in intumescent white cataracts." Journal of Cataract & Refractive Surgery 40.1 (2014): 44-50.
INTUMESCENT DECOMPRESSION/ASPIRATION
Tear outs slow motion video
Femto pattern application
ENGINEER / ONE SECOND FEMTO CCC
FEMTODYNAMICS
RESULTS
SUMMARY