The femtosecond laser transmits pulses of energy of very short duration and with an infrared wavelength that allows it to penetrate the tissues without damaging the structures.
Its main function is based on the separation of the tissues achieving more safety, precision and a quick recovery in patients.
This technique has been used for years in refractive surgery, correction of myopia, hyperopia and astigmatism and has recently been incorporated in cataract surgery.
It has been a revolution in the surgical procedure since it provides advantages over the conventional phacoemulsification technique.
Cataract surgery using the femtosecond laser is divided into 5 steps:
- Capsulotomy. One of the advantages of the laser is its high precision and reliability when performing the circular cut. It also allows adjusting the diameter according to the patient’s parameters.
- Cataract fragmentation. In this second phase, we start from the deepest part of the cataract and move up towards the surface. In this way it is possible to differentiate different types of patterns, depending on the hardness of the cataract.
- Incisions. The position, size, angulation and number of planes are defined according to the surgeon’s preferences. The length and inclination of the incisions can also be selected to avoid incisions that are too corneal, thus reducing the patient’s discomfort.
- Arcuate incisions. One or two incisions can be made to reduce corneal astigmatism. Their location, size and depth are determined by the surgeon taking into account the patient’s preoperative data.
- Implantation of the intraocular lens. The femtosecond laser allows us to achieve better centration of the lens in the capsular bag.
What are the advantages and disadvantages of the femtosecond laser?
Among its advantages are:
- Greater safety, since the laser simply performs a cut of the tissues in a closed chamber.
- Greater reproducibility.
- Precision and accuracy.
- Decreased damage by reducing time and ultrasound energy.
- Rapid recovery.
- Less sedation.
The use of femtosecond laser in cataract surgery implies a high cost, since qualified personnel is involved and disposable material is used.
However, its precision and safety have been shown to minimize damage in cataract surgery and achieve better visual results.