Novel laser platform aims to maximize incision accuracy, minimize damage

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The VICTUS femtosecond laser platform (Bausch + Lomb) creates centered, round capsulotomies and should contribute greatly to the accuracy and predictability of cataract surgeries.

By Lynda Charters; Reviewed by Y. Ralph Chu, MD
 

Bloomington, MN-One of the biggest challenges in cataract surgery is creating a capsulotomy that is of the desired size and perfectly round. A novel femtosecond laser system for cataract surgery-the VICTUS femtosecond laser platform (Bausch + Lomb)-seems to tick all the boxes by creating free-floating capsulotomies that are predictable with few complications without associated suction loss or difficulty docking the instrument, according to Y. Ralph Chu, MD.

The laser is designed for use in the creation of a corneal flap in patients undergoing LASIK or other treatments requiring initial lamellar resection of the cornea, for anterior capsulotomy during cataract surgery, and for creating cuts and incisions in the cornea in patients undergoing cataract surgery or other ophthalmic treatment requiring cuts and incisions in the cornea, Dr. Chu said.

Femtosecond lasers have taken cataract surgery to a new level by maximizing the accuracy of incisions while minimal collateral damage, pulse rates of up to 160 kHz that effectively shorten the procedural time, enhance surgeon control, and has a curved patient interface. In addition, pressure sensors provide a 3-dimensional evaluation of the pressure between the curved patient interface and the eye.

Evidence

Dr. Chu and Dan Davis, OD, from the Chu Vision Institute, Bloomington, MN, conducted a study to test the performance of the laser with the intention of identifying the rates of free-floating capsulotomy with the new, short-pulse femtosecond laser and the rates of complications including subconjunctival hemorrhages. The investigators also looked at any difficulty associated with using the instrument, such as loss of suction and difficulty with docking the instrument.

The patients included in the study underwent cataract surgery with creation of a capsulotomy with a target diameter of 5.5 mm. The investigators recorded information on free-floating capsulotomies and complications intraoperatively for all patients as well as monitored the suction time in a subset of patients. The measurement of the suction time was added at a later stage and data were recorded for 180 eyes, according to Dr. Chu.

The investigators analyzed data from 192 eyes of 129 patients who underwent cataract surgery. The 75 women and 54 men were a mean age of 65.1 years (range, 32 to 83 years).

Dr. Chu reported that a complete, free-floating capsulotomy was created in all eyes, with the exception of one of the 192 cases, and the surgeons reported no difficulty using the device. No suction loss occurred in any eyes. The suction time was 2.5 minutes with a range of 1.7 to 4.2 minutes.  There was no difficulty docking in any eyes. A subconjunctival hemorrhage developed in 30 (15.7%) of the 192 eyes.

“Our data indicated that the laser system successfully creates free-floating capsulotomies and is not associated with suction loss or difficulty docking,” Dr. Chu said. “The laser system maximizes the accuracy of the incisions while minimizing collateral damage.”

Y. Ralph Chu, MD

E: yrchu@chuvision.com

Dr. Chu is a consultant to Bausch & Lomb.