Latent Need for Femto Phaco
November 10, 2010DrHovanesian No Comments »The Latent Need for Femto Phaco
Many surgeons’ attitudes toward femtosecond cataract surgery seem to be a mix of excitement with a bit of resentment. While everyone wants safer, more precise surgery, we all wonder what patients can pay for this new level of premium surgery? Many also wonder how much better cataract surgery can become. While the market value of femto phaco can only be determined by patient response once the machines are available on a large scale, the latter question deserves some exploration.
As they did with ultrasound phaco surgery in the 1980s, early adopters will help define the technical value of femtosecond-assisted cataract surgery, but this value also depends upon other technologies that the lasers will allow.
There are three reasons I believe we should be enthusiastic about femto-phaco technology:
- Safer and more precise surgery now. There is still little but fairly convincing evidence that precisely-controlled corneal incisions and capsulotomies yield much more precise surgical outcomes. We need more data, and we will have it soon. Meanwhile, ask yourself whether you would want femto-assisted cataract surgery on your own eyes if you had to have surgery today. If we answer yes (as I would), why would we not offer this to patients?
- Technologies in development. Lenses like the AMO Visiogen Synchrony Dual-Optic accommodating lens, the PowerVision accommodating lens, and the Nu-lens accommodating lens all will deliver better results than existing accommodating IOLs but will depend upon a greater degree of control of capsular dynamics. Femtosecond cataract surgery will allow more surgeons to benefit from these coming technologies.
- Technologies we haven’t even considered. Once we have the ability to make precise incisions inside the eye, a whole new array of technologies can come into consideration, such as lens-filling technologies, IOLs that hang on the anterior or posterior capsulotomy, still newer accommodating designs, and who knows what else?
When phacoemulsification first became available, the resentment to the new technology was even more palpable than it is today toward femto-phaco. It was only a matter of time before skepticism gave way to optimism and excitement for this innovation. It seems that history is likely to repeat itself.
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