Femtosecond laser cataract surgery: technology and clinical practice

Roberts, Timothy V.; Lawless, Michael; Chan, Colin; Jacobs, Mark; Ng, David; Bali, Shveta Jindal; Hodge, Chris; Sutton, Gerard

doi:10.1111/j.1442-9071.2012.02851.x

Cited by 81 publications

(63 citation statements)

References 24 publications

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“…8 For example, in fs-laser cataract surgery, ultrashort laser pulses of several mJ are currently used for the rhexis of the lens capsule and for the fragmentation of the cataractous lens tissue to simplify its extraction. 9,10 A similar strategy is applied in the concept of fs-laser presbyopia treatment, which aims to restore the elasticity of the lens by inducing laser disruptions in the hardened lens nucleus. [11][12][13] Moreover, fs-laser-induced cuts within the vitreous body may reduce vitreous traction and are therefore discussed as a preventive therapy for posterior vitreous detachment.…”

Section: Introductionmentioning

confidence: 99%

Enhancing precision in fs-laser material processing by simultaneous spatial and temporal focusing

et al. 2014

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In recent years, femtosecond (fs)-lasers have evolved into a versatile tool for high precision micromachining of transparent materials because nonlinear absorption in the focus can result in refractive index modifications or material disruptions. However, when high pulse energies or low numerical apertures are required, nonlinear side effects such as self-focusing, filamentation or white light generation can decrease the modification quality. In this paper, we apply simultaneous spatial and temporal focusing (SSTF) to overcome these limitations. The main advantage of SSTF is that the ultrashort pulse is only formed at the focal plane, thereby confining the intensity distribution strongly to the focal volume and suppressing detrimental nonlinear side effects. Thus, we investigate the optical breakdown within a water cell by pump-probe shadowgraphy, comparing conventional focusing and SSTF under equivalent focusing conditions. The plasma formation is well confined for low pulse energies ,2 mJ, but higher pulse energies lead to the filamentation and break-up of the disruptions for conventional focusing, thereby decreasing the modification quality. In contrast, plasma induced by SSTF stays well confined to the focal plane, even for high pulse energies up to 8 mJ, preventing extended filaments, side branches or break-up of the disruptions. Furthermore, while conventional focusing leads to broadband supercontinuum generation, only marginal spectral broadening is observed using SSTF. These experimental findings are in excellent agreement with numerical simulations of the nonlinear pulse propagation and interaction processes. Therefore, SSTF appears to be a powerful tool to control the processing of transparent materials, e.g., for precise ophthalmic fs-surgery.

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Section: Introductionmentioning

confidence: 99%

Enhancing precision in fs-laser material processing by simultaneous spatial and temporal focusing

et al. 2014

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“…A smaller mean absolute error is associated with better predictability of IOL power calculation. Six weeks after surgery, the mean absolute error was significantly lower in the laser group find a significant difference between the groups in terms of other measures of visual outcomes, including manifest refraction SEQ, corrected distance visual acuity, and mean error.Roberts et al139 found no significant difference in visual outcomes in a prospective study of 113 FLACS procedures versus 105 conventional cases. The absolute mean difference from intended correction was 0.29 ± 0.25 D for the FLACS group and 0.31 ± 0.24 D for the standard group (p=0.5).…”

mentioning

confidence: 98%

Femtosecond laser–assisted cataract surgery—current status and future directions

Grewal

Schultz²,

Basti

et al. 2016

Survey of Ophthalmology

115

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“…Thus, FLACS is expected to yield a more accurate effective lens position, IOL calculation, uncorrected visual acuity, and decreased higher order aberrations, IOL calculation and uncorrected visual acuity. However, the results of the few published studies are inconsistent and thus more research is needed [79][80][81].…”

Section: Femtosecond Laser-assisted Cataract Surgerymentioning

confidence: 94%