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Cataract surgery with greater control and predictability

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Dr Mark Cherny, The Cataract Clinic of Victoria

Product: Catalys Precision Laser Cataract System

Supplier: Designs For Vision

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The Catalys Precision Laser Cataract System is an extraordinary technological achievement. It is designed to increase the precision and safety of cataract surgery and it does just that.

In March 2011, I was introduced to the concept of laser-assisted cataract surgery. Having used femtosecond lasers for several years in the creation of LASIK flaps, I knew the power of the modality to deliver greater surgical control and predictability. It was logical for me to embrace the opportunity to bring the same benefits to my cataract surgery theatre.

The difficult question lay in which of the four available platforms I should choose. After travelling extensively and networking with the key clinicians globally, I concluded that the Catalys had several unique benefits that made it the system of choice.

The Catalys integrates spectral domain OCT imaging of the anterior segment and femtosecond laser to allow for the capsulotomy, nuclear pre-division, nuclear softening, incisions and limbal relaxing incisions to be performed.

Integral Guidance is the proprietary software process that allows templates for treatments to be readily created and then assimilated into each individual treatment. The user interface for the surgeon is a large touch-screen with intuitive graphics that any iPhone or iPad user will find easy.

E020-image-1-Catalys-SystemWork-flow and time to treat patients are often cited as a challenge to introducing laser-assisted cataract surgery. We were fortunate to be able to create a three-by-four metre room in our theatre suite, which can service two operating theatres. Typically, patients spend five minutes in the laser room and 20 minutes in the theatre. This allows me to comfortably treat two patients an hour, which is the same length of time per patient as we have traditionally achieved with standard phaco-emulsification.

Since its arrival in my centre in July 2012, I have used the Catalys on all my patients requiring cataract or lens surgery, apart from when there are contraindications, which is almost never. I have performed almost 400 treatments and know that this is the safest and most consistent surgery I have performed in my 20 plus years of cataract surgery.

At the Hawaiian Eye meeting in January 2013, I spoke with two leading American surgeons who had each used three different femtosecond cataract systems, and both agreed that the Catalys was their preferred system. Among dozens of surgeons I have spoken to in recent months, there is a strong consensus that Catalys is currently the system of choice for safety, reliability and ease of use. It is also the most expensive.

I have had zero dropped nuclei, zero infections, zero maculopathy and zero corneal decompensation. Phacoemulsification energy times have been dramatically reduced. On many operating lists, at least half the patients require zero ultrasound energy as the pre-softened lens is removed entirely with aspiration alone.

Standard phacoemulsification usually delivers very good results, but sometimes unpredictable serious complications arise. In our community, we are obliged to find the tools and techniques to eliminate all risks of serious complications, and I believe this technology takes us closer to that goal.

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If surgeons ask themselves ‘What was the last serious complication in cataract surgery I saw?’ and then ask ‘Could this have been avoided with laser-assisted cataract surgery?’ the answer is likely to be ‘yes’.

Most patients place a huge value on safety when having elective eye surgery. Efforts will have to be made to use this and other new technologies efficiently. To make these technologies affordable, surgeons will inevitably coalesce into a small number of high-technology, high-volume ophthalmic theatres. Laser systems will not be installed in every hospital or day surgery in Australia.

Our patients deserve the best care we can give them. They deserve the right to know that the option of laser-assisted cataract surgery exists and the results it is achieving. 

Dr Mark Cherny is the founder and director of The Cataract Clinic of Victoria and is the founder of The International Society for Laser Cataract Surgery.




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