Laser Cataract Surgery
 

The Manhattan Eye, Ear, and Throat Hospital (210 East 64th Street) has acquired the OptiMedica Catalys Precision Laser System. The foundation of this technology is the INTEGRAL GUIDANCE System - a proprietary 3D Full Volume Optical Coherence Tomography (OCT) with automated surface mapping algorithms that guide laser delivery and is depicted here. Although the Catalys System does not actually perform cataract surgery, this femto-laser does prepare the eye for cataract extraction in several unique ways. First, it can create a perfectly round Capsulorhexis. The cataract is enveloped in a capsular bag. To access the cataract, the anterior capsular bag is opened manually by a continuous tearing maneuver as shown below.  It has been postulated that the laser-generated capsulorhexis may provide improved intraocular lens positioning and thereby improved acuity when a multifocal iol has been implanted. For a video explaining the multifocal iol that Dr. Rubman prefers click here. The advanced Tecnis Symfony Extended Range of Vision IOL is explained here.
 


The second, and probably most import feature of the Catalys System is its ability to soften a very hard cataract prior to its removal with phacoemulsification, (discussed here). Cataracts vary considerably in their consistency, from soft to very hard. Although it is possible to removal any cataract via phacoemulsification, a very dense cataract that has been pre-softened and divided by the femto-laser is more easily and more safely removed. In fact, operating on any cataract that has been pre-segmented and pre-softened becomes an easier and more gentle procedure. The Catalys System technology is compared to the manual approach here. A slit-lamp photo of a dense cataract is shown  below.

 

The third feature of the Catalys System is its capability of creating extremely accurate arcuate incisions to reduce or eliminate corneal astigmatism. While it is certainly possible to make accurate manual arcuate incisions (click here for this discussion), the femto-laser can perform these even more precisely. The actual video screen which the surgeon views while performing these procedures is shown here.

A promotional video of the OptiMedica Catalys System released by the company can be found here. The informed consent for Laser Cataract Surgery is here (it is identical to the standard phacoemulsification consent video with the exception that the role of the Catalys System is included). An actual procedure using the Catalys can be found here.

 

 

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