An OD’s perspective of laser cataract surgery

Associate Optometric Editor Katherine M. Mastrota, OD, shared an OD’s perspective of laser cataract surgery at the 90th annual SECO International meeting in Atlanta:

Steven Holbrook, OD, of Bloomington, IN, reviewed complications associated with laser-assisted cataract surgery. In addition to the risks inherent with standard cataract surgery, Dr. Holbrook discussed:

• Loss of suction (during docking at the start of the case)
• Incomplete incisions

• Incomplete rhexis leading to capsular runoff (capsular tear)

• Gas breakthrough and posterior capsule blowout

• Descemet’s detachment

• Poor centration due to tilt effect

• Subconjunctival hemorrhages (from docking suction)

• Corneal erosions (primarily with pre-existing epithelial basement membrane dystrophy)

• Wound leak

• Episcleritis (possibly from the suction ring)

• Astigmatism over/under correction

Dr. Holbrook explained that these complications are exceptions and may be related to the surgeon’s learning curve with the new instrumentation. As surgeons become more proficient in laser-assisted surgery and femtosecond technology becomes more refined, Dr. Holbrook expects that the technology will become standard due to superb refractive outcomes in cataract surgery, particularity in this age of premium IOLs.