Description
Cataract surgery is the most commonly performed
surgical procedure in the world, with an estimated
19 million operations performed annually, nearly 3
million of which are performed in the United States.1
The World Health Organization estimates this number
will increase to 32 million by the year 2020 as the over-
65 population doubles worldwide between 2000 and
2020.2 Globally, more than 3000 eye surgeons (more
than 1000 United States surgeons) have been trained.
Femtosecond laser technology, introduced clinically
for ophthalmic surgery in 2001 as a new technique
for creating lamellar flaps in laser in situ keratomileusis
(LASIK), has recently been developed into a tool for
cataract surgery.3
Given the recent introduction of this technology, the
conventional nomenclature for these procedures is
inconsistent. At the 2012 American Society of Cataract
and Refractive Surgery meeting, a survey of 30 practices
revealed 29 different names used for this procedure.
The more common acronyms include ReLACS
(refractive laser–assisted cataract surgery), FLACS
(femtosecond laser–assisted cataract surgery), and
FALCS (femtosecond–assisted laser cataract surgery).4
Agarwal proposes ReLACS and T-LACS (therapeutic
laser–assisted cataract surgery) to refer to refractive
procedures and therapeutic applications (surgically
challenging casesddense nuclei), respectively.4
While this technology has the potential to improve
safety, accuracy, and clinical outcomes, the femtosecond
laser–assisted cataract surgery procedure
brings with it a host of new clinical and financial
challenges. This article describes clinical aspects of
the new surgical technique and discusses the currently
available femtosecond laser–assisted cataract surgery
equipment, the benefits and challenges of this new
technology, and the logistics of incorporating these
systems into a clinical practice.