Cataract surgery developments will help improve safety, efficiency, vision recovery

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We are in an exciting wave of developments in cataract surgery that has brought an increased focus on safety, efficiency and rapid vision recovery. These innovations are reshaping how we approach patient outcomes and surgical techniques.

One major aspect of this progress is the newest generation of phacoemulsification machines. These machines have undergone significant improvements in recent years, generating excitement particularly around advancements in fluidics and phaco energy optimization. I have had the privilege of working with some of the companies bringing these new technologies to market. A key area of focus has been optimizing fluidics to approach a more physiologic IOP, which enhances patient comfort and postoperative recovery.

Some of the newer machines, such as Alcon’s Unity cataract system and vitreoretinal cataract system, feature substantial advancements, including advances in phaco technology that allow for more efficient phacoemulsification, with smart fluidics enabling cataract fragments to aspirate more easily and move effortlessly to the tip. Additionally, it also provides much greater chamber stability, even when operating at intraoperative pressures as low as mid 20s mm Hg. This next generation of phaco machines is prioritizing better outcomes by balancing safety, patient comfort and operational efficiency.

As surgeons, the increasing demand on our time makes it critical for us to feel both safe and highly efficient in the operating room. These machines strive to deliver on that promise.

Another exciting area of improvement is femtosecond laser-assisted cataract surgery. Advances in image guidance technology and laser precision are enhancing premium lens implantation. By leveraging preoperative diagnostic images, we are able to guide laser treatment patterns, which improves surgeon confidence when implanting toric and presbyopia-correcting lenses. For example, the Ally femtosecond laser (Lensar) can create a small nub in the capsule so the toric can be perfectly aligned on the desired axis.

The entire process has become more streamlined, with lasers becoming faster and more efficient. In the past, there was concern that incorporating lasers could slow down a cataract surgeon. However, advancements such as iris registration image guidance and toric alignment assistance, as well as integrated femtosecond laser combined with phacoemulsification, have further optimized the workflow. Personally, I rely less on intraoperative aberrometry and other modalities for toric lens alignment as the innovations in laser technology described have provided me with greater accuracy and ease of use. These advancements have made the experience not only more efficient but also more enjoyable for surgeons like me.

Neda Shamie, MD, a Healio/OSN Board Member, can be reached at ns@maloneyshamie.com.

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Source:
Expert Submission

Disclosures:
Shamie reports consulting for Alcon, Bausch + Lomb, Johnson & Johnson, Lensar and Zeiss.

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