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Femtosecond Laser-Assisted Cataract Surgery (FLACS)

Femtosecond Laser-Assisted Cataract Surgery (FLACS). MR Jafarinasab MD Labbafinejad Medical Center. www.iranophthalex.com. Introduction.

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Femtosecond Laser-Assisted Cataract Surgery (FLACS)

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  1. Femtosecond Laser-Assisted Cataract Surgery (FLACS) MR Jafarinasab MD Labbafinejad Medical Center www.iranophthalex.com

  2. Introduction • Cataract surgery is one of the most frequently performed surgeries in the world today, enabling millions of people to regain eyesight lost because of cataracts. • Modern cataract surgery is safe, effective and highly predictable . • Surgical tools and techniques are constantly evolving to make the procedure even better.

  3. Complications of Traditional PECataract surgery complications are still10x that of LASIK LASIK(

  4. Femtosecond Laser-Assisted Cataract Surgery (FLACS) Objectives: • Increase safety • Improve precision • Automate undependable components

  5. ContemporaryCataractSurgery Steps: • Incision • Capsulorhexis • Phacoemulsification • IOL Insertion • Relaxing Incisions (Astigmatism)

  6. Cataract Incisions: • Wound construction is critical in modern cataract surgery because it is the BASIC step • A poorly constructed wound will • make subsequent steps more • difficult and increase the risk of • complications. • A well-constructed wound is the first step in successful surgery for both the surgeon and the patient.

  7. Potential Problems in manual Capsulorhexis • Small • Large • Eccentric • Irregular

  8. FS Laser-assisted vs ManualCapsulorhexis

  9. FS Laser-assisted vsManual Capsulorhexis

  10. Femtosecond Laser-Assisted Lens Fragmentation & Softening

  11. Femtosecond Laser-Assisted Lens Fragmentation & Softening

  12. Relaxing Incision for Astigmatism:

  13. Historical Background • 2008: First surgery performed by Zoltan Nagy in Budapest using Alcon Lensx Laser • 2009: Alcon Lensx became first laser to receive FDA approval for Cataract surgery • 2010: First surgery performed in United States performed by Stephen Slade

  14. FS laser cataract surgery procedure • Stages of FS laser cataract surgery procedure • 1-Planning • 2-Engagement(Docking) • 3-Visualization and customization • 4-Treatment

  15. Docking (Engagement) • Prior to delivery of the laser, a patient’s eye must be stabilized relative to the optical system of the laser. • In refractive surgery, this is achieved with a curved or flat plate that pulls the eye into a suction ring, distorting the globe • In FLACS another option is liquid interface

  16. Visualization and customization • The image guidance system is a critical part of laser cataract surgery as it determines the location and dimension of ocular structures • It is critical that the posterior surface of the lens ( Posterior Capsule ) be detected in order to maintain a safety zone and prevent cuts in the posterior capsule

  17. Visualization and customization • LenSx and OptiMedica use FD-OCT for three- dimensional, high-resolution viewing of ocular structures. • LensAR uses a three-dimensional confocal structured illumination- scanning transmitte very similar to Scheimpflug technology . • Additionally, the lens density can be valuated

  18. FS Laser-assisted Cataract SurgeryImaging and Registration: OCT Technique (Optimedica) Scheimpflug Technique (LensAR)

  19. Treatment

  20. 1. Lensx _ animation 2. lens_aspiration_ii 3. lens_fragmentation_ii 4.anterior_capsulotomy

  21. FS Laser-Assisted Cataract Surgery:The Future: • Sub Bowman’s Relaxing Incisions • Complex Cataract Incisions • Customized Capsulorhexis • Posterior Capsulotomy • Capsulorhexis Integrating with IOLs - “Capsule in the Lens” - Toric IOL Orientation • IOL Power Adjustment • Lens Refilling Surgery

  22. FS Laser-assisted Cataract Surgery:Advantages and Disadvantages: • Advantages: • Improved safety • Increased precision • Enhanced reproducibility • Disadvantages: • Increased Cost • Added time

  23. Conclusion: • William J. Link, Ph.D., Newport Beach, Calif., • when a new technology is introduced, "there's always this beautiful, awkward, disruptive time where we try to sort it out and debate, and then it will be refined with data and experience." • Dr. Link believes that in the future, cataract surgery will be dramatically different because of the advent of the femtosecond platform. • "For that to happen, it has to work economically, • It has to be good for the patient, • it has to be good for the practice, • it has to be good for the company.

  24. Thank you

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