Wednesday, November 6, 2013, 10:00am – 11:30am, in 489 Minor Hall

Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography

presented by

Daniel Palanker, Ph.D.
Associate Professor Department of Ophthalmology and Hansen Experimental Physics Laboratory
Stanford University

 

Conventional cataract surgery involves manual formation of incisions in the cornea and opening in the anterior lens capsule, as well as fragmentation and evacuation of the lens tissue with an ultrasonic probe prior to implantation of an artificial intraocular lens into the remaining capsular bag. The size, shape, and position of the anterior capsular opening (one of the most critical steps in the procedure) are controlled by freehand pulling and tearing of the capsular tissue. In addition, manual corneal relaxing incisions are limited in precision of their position, shape and depth.

We developed a technique that improves the precision and reproducibility of cataract surgery by performing anterior capsulotomy, lens segmentation and corneal incisions with a femtosecond laser. The cuts placement is determined by imaging the anterior segment of the eye with integrated optical coherence tomography. To eliminate corneal folding and minimize the rise of intraocular pressure the laser system is coupled to the eye using liquid immersion interface. Femtosecond laser produces continuous anterior capsular incisions, which are twice stronger and more than five times more precise in size and shape than manual capsulorhexis. Lens segmentation and softening simplifies its emulsification and reduces the amount of ultrasonic energy during its removal, decreasing the perceived cataract hardness by two grades and minimizing the loss of the corneal endothelial cells. Three-dimensional image-guided cutting of the cornea creates multi-planar self-sealing incisions and allows exact placement of the limbal relaxing incisions, thereby increasing the safety and performance of cataract surgery.

 

Host: Christine Wildsoet

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