New patient interface enhances laser refractive cataract surgery

Take-Home Message

A new patient interface improved the usability and performance of a femtosecond laser system in a multicenter study.

Dr. Slade

By Lynda Charters; Reviewed by Stephen Slade, MD

Houston-A new patient interface (SoftFit, Alcon Laboratories/LenSx) designed for laser refractive cataract surgery seems to improve the usability and performance of the femtosecond laser system with lower laser energy applied to the eye and increased patient comfort.

The interface is a one-piece device with a hydrogel contact lens that is positioned in the applanation cone with the goal of preventing corneal folds that can interfere with introduction of the laser energy into the eye.

In contrast to the original patient interface, the design of the new interface has an extended suction ring skirt that allows a soft contact lens to be places next to the patient interface glass. With the soft contact lens in place, the IOP remains much lower during the procedure.

“The new interface is the single most important improvement to the LenSx laser, which has been continually refined and developed,” said Stephen Slade, MD, in private practice, Houston.

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Evaluation of technology performance

In a prospective multicenter study designed to determine the surgical outcomes with the patient interface, Dr. Slade and Michael Knorz, MD, professor of ophthalmology, medical faculty, University of Heidelberg, Mannheim, Germany, evaluated the performance of the technology during image-guided femtosecond laser capsulotomies in 77 eyes. The investigators assessed the:

• Ease of docking.

• Corneal compression.

• Quality of the capsulotomy and fragmentation.

• Quality of the edge of the capsule.

The capsulotomies were judged and graded as free floating, type 0 with a complete laser cut, type I with microadhesions or perforations, or type II with areas that were undercut. The fragmentation was graded as having achieved completely defined quadrants or roughly defined quadrants and as having had little or no laser effect.

Results showed that 99% of the capsulotomies were free floating, according to Dr. Slade. Fragmentation was complete with defined quadrants in 94% of cases. The corneal incisions were open using blunt dissection in 95% of cases. All cases in which creation of a capsulotomy, fragmentation, and corneal incisions were attempted were completed.

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The docking procedure was considered easy in 97% of cases, Dr. Slade noted. There was no fogging as a result of the soft contact lens insert in 100% of cases, and 100% of cases had no corneal wrinkles. In addition, it was considered comfortable for patients.

The new patient interface improved the usability and performance of the laser system, he noted.

“In addition, no on-eye assembly of the interface or fluid is required,” Dr. Slade concluded. “Patients are more comfortable with the easier and more gentle docking procedure, and less corneal distortion also makes patients more comfortable.”

Further reading: How to spend $450 million wisely

Stephen Slade, MD

E: sgs@visiontexas.com

Dr. Slade is a consultant for Alcon Laboratories, Bausch + Lomb, Clarity, Glaukos, ReVision Optics, and WaveTec Vision.