Top 10 Innovations for 2013
#6 Femtosecond Laser Cataract Surgery
The eye is a complex organ that sends nerve impulses to the brain when stimulated
by reflected light rays. The brain can then process these impulses and create the
perception of vision.
The lens of the eye is a clear structure that stretches and contracts and allows us to
focus on objects at various distances. With aging, however, cataracts, one of the most
common eye ailments, can develop. These are dead cells that accumulate in the lens
capsule, causing the lens to gradually become cloudy. As these spots increase in size,
vision is no longer clear and sharp. The opaque areas on the lens make people feel as
if they are now seeing everything through a fog-covered window.
In the United States, 75% of people over age 60 have some sign of cataracts. In
most individuals any vision loss from cataracts can be corrected by surgery, which
is a common, safe, and effective way of replacing the clouded lens. In fact, cataract
surgery is the most commonly performed surgical procedure in the United States and
is considered by many doctors to be the most effective surgical procedure in all of
medicine. The American Academy of Ophthalmology estimates that 1.6 million cataract
operations are performed each year in the United States.
Cataract surgery, called phacoemulsification, involves removing all or part of the
damaged natural crystalline lens and replacing it with an intraocular lens implant to
provide vision correction, often eliminating the need for eyeglasses or contacts. Cataract
removal, which is done freehand with a surgical blade, will improve vision in more than
95% of cases if the eye is normal except for the cataract.
While surgical results have been outstanding, cataract surgery has now been
improved with the introduction of femtosecond laser technology. The device has
already been used successfully in ophthalmology, particularly for LASIK (Laser In-Situ
Keratomileusis) refractive surgery.
A femtosecond is one quadrillionth of a second. This is the super-fast amount of time that numerous laser
pulses of near infrared light are used by a surgeon in this new cataract procedure. The femtosecond laser
helps make a perfect circular hole in the lens capsule, splits the lens into sections, and then softens and
breaks up the cataract. The damaged lens is removed using ultrasound and an intraocular lens is then
Unlike a surgical blade that cuts, a femtosecond laser separates tissue by ablating and cleaving it. The novel
FDA-approved bladeless cataract procedure is now revolutionizing surgery by making it more predictable and
accurate, allowing surgeons to make smaller, more precise incisions. It also requires less energy time inside
the eye, causes less inflammation, and offers more stability when implanting a new lens.
The combination of precision and simplification that is possible with femtosecond laser represents a major
advance for cataract surgery.