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Emerging Technology in Refractive Cataract Surgery.

Saraiva J, Neatrour K, Waring Iv GO - J Ophthalmol (2016)

Bottom Line: Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients.Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs).This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

View Article: PubMed Central - PubMed

Affiliation: Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA.

ABSTRACT
Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients. Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs). This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

No MeSH data available.


Related in: MedlinePlus

Surgeon view of eye after femtosecond laser capsulotomy lens softening and limbal relaxing incision with the Catalys laser.
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fig4: Surgeon view of eye after femtosecond laser capsulotomy lens softening and limbal relaxing incision with the Catalys laser.

Mentions: The size, shape, and position of a capsulotomy should theoretically lead to a more predictable lens position by enhancing uniform capsule-optic overlap, thereby reducing the incidence of lens tilt and leading to an overall better effective lens position and visual outcome (Figure 4). Recently, Toto and colleagues found no difference in prediction error when comparing traditional phacoemulsification with FLACS but did find higher refractive stability and IOL centration with FLACS [33]. This similarity in prediction error may be a consequence of unexplored potential with IOL calculations and algorithms. Dr. Ma approached the prediction of true lens position using an algorithm based on OCT anterior segment 3-D reconstruction [34]. This prediction model could have great potential once there is consistent alliance of OCT measurements with FLACS to provide more precise outcomes. This is particularly relevant with premium IOLs, as there is a lower tolerance threshold for minor unanticipated miscalculation and decentration. Okulix (Tedics Peric & Joher GbR, Dortmund, Germany) is an innovative software program that calculates IOL power using ray tracing combined with corneal topography. Saiki et al. evaluated its accuracy in post-LASIK eyes in comparison with Camellin-Calossi, Shamas-PL, Haigis-L formulas and double-K SRK-T method. They reported that this technology provides sufficient predictability outcomes in postrefractive myopic LASIK, even though a small hyperopic shift tendency was noted in the study [35]. The Galilei G6 Lens professional (Ziemer, Port, Switzerland) is an optical biometer that integrates Placido rings with a dual rotating Scheimpflug camera as well as an optical coherence tomography based A-scan in a single device. Shin et al. compared its accuracy with the Lenstar LS 900 (Haag-Streit, Koeniz, Switzerland), for intraocular lens (IOL) power calculation. They noted that axial length, lens thickness (LT), and white-to-white (WTW) values were statistically different. Thus, even though high repeatability was present, and the IOL powers were not statistically different between the two devices, the values provided by the Galilei G6 were not interchangeable with the Lenstar in the clinical setting [36].


Emerging Technology in Refractive Cataract Surgery.

Saraiva J, Neatrour K, Waring Iv GO - J Ophthalmol (2016)

Surgeon view of eye after femtosecond laser capsulotomy lens softening and limbal relaxing incision with the Catalys laser.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4940542&req=5

fig4: Surgeon view of eye after femtosecond laser capsulotomy lens softening and limbal relaxing incision with the Catalys laser.
Mentions: The size, shape, and position of a capsulotomy should theoretically lead to a more predictable lens position by enhancing uniform capsule-optic overlap, thereby reducing the incidence of lens tilt and leading to an overall better effective lens position and visual outcome (Figure 4). Recently, Toto and colleagues found no difference in prediction error when comparing traditional phacoemulsification with FLACS but did find higher refractive stability and IOL centration with FLACS [33]. This similarity in prediction error may be a consequence of unexplored potential with IOL calculations and algorithms. Dr. Ma approached the prediction of true lens position using an algorithm based on OCT anterior segment 3-D reconstruction [34]. This prediction model could have great potential once there is consistent alliance of OCT measurements with FLACS to provide more precise outcomes. This is particularly relevant with premium IOLs, as there is a lower tolerance threshold for minor unanticipated miscalculation and decentration. Okulix (Tedics Peric & Joher GbR, Dortmund, Germany) is an innovative software program that calculates IOL power using ray tracing combined with corneal topography. Saiki et al. evaluated its accuracy in post-LASIK eyes in comparison with Camellin-Calossi, Shamas-PL, Haigis-L formulas and double-K SRK-T method. They reported that this technology provides sufficient predictability outcomes in postrefractive myopic LASIK, even though a small hyperopic shift tendency was noted in the study [35]. The Galilei G6 Lens professional (Ziemer, Port, Switzerland) is an optical biometer that integrates Placido rings with a dual rotating Scheimpflug camera as well as an optical coherence tomography based A-scan in a single device. Shin et al. compared its accuracy with the Lenstar LS 900 (Haag-Streit, Koeniz, Switzerland), for intraocular lens (IOL) power calculation. They noted that axial length, lens thickness (LT), and white-to-white (WTW) values were statistically different. Thus, even though high repeatability was present, and the IOL powers were not statistically different between the two devices, the values provided by the Galilei G6 were not interchangeable with the Lenstar in the clinical setting [36].

Bottom Line: Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients.Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs).This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

View Article: PubMed Central - PubMed

Affiliation: Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA.

ABSTRACT
Technology in cataract surgery is constantly evolving to meet the goals of both surgeons and patients. Recent major advances in refractive cataract surgery include innovations in preoperative and intraoperative diagnostics, femtosecond laser-assisted cataract surgery (FLACS), and a new generation of intraocular lenses (IOLs). This paper presents the latest technologies in each of these major categories and discusses how these contributions serve to improve cataract surgery outcomes in a safe, effective, and predictable manner.

No MeSH data available.


Related in: MedlinePlus