Laser Refractive Cataract Surgery

A new laser therapy that can potentially remove cataracts from people's eyes more efficiently and with greater precision was presented on October 24, 2009 at the American Academy of Ophthalmology (AAO) annual meeting. The technology, currently undergoing clinical trials outside the USA, was developed by LenSar, a start-up company which is in a head-to-head competition with two other players to be the first to commercialize the technology. LenSar plans to start treating patients if the FDA will consider the results of the remaining trials to be both safe and effective.

Although the new device will cost more than existing technologies, the speed of surgery may compensate for that by allowing more procedures to be performed in less time. The new laser cataract device is designed to be safer and easier to use, and it is believed that most cataract surgeons can learn to use it to perform surgeries with less complications. The laser will allow for the use of "premium" implants which set up bifocal vision as well as provide a better way to treat astigmatism.

The LensAR system will not only deliver precise all laser capsulotomies, CCIs and LRIs, but laser fragmentation of the cataract. This approach will significantly reduce, and even eliminate the use of ultrasound power in most cases.

Five years ago, I brought together a group of gifted engineers and scientists, many of whom, I had worked with on the successful development and launch of the Autonomous laser-radar tracking and small spot scanning excimer system that set a new standard in precision in LASIK surgery, when approved by the FDA in 1998. Measurement guided beam delivery was taken to a whole new frontier when Autonomous delivered wavefront guided custom LASIK treatments to ophthalmology. 

This time, I challenged the team to design and develop a highly integrated measurement technology within a 3-dimensional scanning femtosecond laser system capable of performing many types of surgical incisions, in eyes of all shapes and sizes.  We are specializing in laser cuts in refractive cataract surgery that are critical to successful surgical outcomes: cuts that are currently performed with a blade, or with ultrasound, and therefore, prone to a measureable degree of variability.  

The LensAR approach is to bring the accuracy and precision of lasers into the operating room to replace blades and greatly reduce, if not eliminate, the need for ultrasound power to perform the majority of cataract removals. The design goals also requires that the system increase the overall surgical efficiency and safety of lens removal, and improve the stability of the intraocular lens placement.

The result is the LensAR (femtosecond) laser system, a seamless integration of an advanced femtosecond laser and proprietary measurement and laser scanning technology. The LensAR laser system is being designed to provide flexible, all laser surgical options for clear corneal incisions, paracenteses, limbal relaxing incisions, lens fragmentation and customizable capsulotomies - all in one procedure.

To date, the LensAR laser system has been successfully used in well over a hundred eyes outside of the US, and is actively under review with the FDA for approval for use in the US.

As we complete our surgical and technology webpages, you will be able to look at surgical footage of our investigators Dr. Ramon Naranjo and Dr. Jorge Villar from Mexico City, and to hear candid comments from leading US surgeons that also have experience with the LensAR laser: David Chang, MD, William Fishkind, MD and Louis “Skip” Nichamin, MD.

For more information, visit LenSar's website at www.lensarinc.com.