CATALYS® Precision Laser System

The CATALYS® Precision Laser System is indicated for use in patients undergoing cataract surgery for removal of the crystalline lens.  Intended uses in cataract surgery include anterior capsulotomy, phacofragmentation, and the creation of single plane and multi-plane arc cuts/incisions in the cornea, each of which may be performed either individually or consecutively during the same procedure.

Femtosecond laser assisted cataract surgery offers a reproducible, noninvasive technique to replace the least predictable and most technically demanding steps of conventional cataract procedures.

Why Laser Cataract

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Designed for Laser Cataract Surgery

Designed specifically for laser cataract surgery, the CATALYS® System offers:

  • LIQUID OPTICS Interface, gentle docking with minimal intraocular pressure rise and clear optics for excellent imaging and laser delivery
  • INTEGRAL GUIDANCE System – proprietary 3D Full Volume Optical Coherence Tomography (OCT) and automated surface mapping algorithms that guide laser delivery
  • Precise capsulotomies within 30µm
  • Complete segmentation and softening of the cataract with adjustable grid sizing
  • Multiple corneal incision centration options that are based on anatomical landmarks

The CATALYS® Precision Laser System combines a <600 femtosecond laser, gentle LIQUID OPTICS Interface, and integrated 3D Full Volume Optical Coherence Tomography (OCT) image-guidance system to create precise incisions in the lens and cornea. The CATALYS® System was developed in close collaboration with a medical advisory board of cataract experts from around the world. In 2012, the CATALYS® System was recognized as one of the top 100 technological innovations in the world.

Throughout the development of the CATALYS® System, numerous technology choices were made aimed at delivering excellent precision. Two of the most critical components are the patient docking interface and the image-guidance system. The LIQUID OPTICS Interface is designed to provide a stable, gentle dock and a clear optical path for the OCT and laser.

In addition, the CATALYS® System is equipped with INTEGRAL GUIDANCE System, an image-guidance system which maps ocular surfaces, establishes safety zones allowing the physician to select and customize the treatment, ensuring that the femtosecond laser pulses are delivered precisely to the intended location.

Understanding the user experience is another critical area focus for the CATALYS® System development team. The system’s intuitive and ergonomically designed user controls were developed with the needs of the patient, surgeon, technician and nurse in mind. A Medical Advisory Board of cataract experts and Medical Staff Advisory Board of dedicated technicians and nurses have had extensive input in system design and usability.

 The CATALYS® System procedure consists of four steps:

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The CATALYS® System includes design features that optimize the precision, safety and control of all four steps of the procedure. Two of the key features that were developed to help surgeons deliver predictability and quality of outcomes are:

LIQUID OPTICS Interface

The novel two-piece liquid interface docks the patient to the system and is designed to provide:

  • A clear optical path for real-time video, OCT imaging, and laser treatment by:
  • Filling in corneal surface irregularities with liquid
    Creating a wide field of view, enabling all cuts to be performed in a single dock

A gentle dock for the patient by:

  • Minimizing the rise in intraocular pressure, which is particularly important for older cataract patients and those with glaucoma
  • Minimizing scleral contact of the interface with minimal redness of the eye after surgery

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INTEGRAL GUIDANCE System

During the CATALYS® System procedure, the ocular surfaces are visualized by a proprietary, integrated Optical Coherence Tomography (OCT) system. The OCT is enhanced by sophisticated algorithms designed to ensure that the femtosecond laser pulses are delivered precisely to the intended location.

Steps in the INTEGRAL GUIDANCE System process:

Proprietary, 3D spectral-domain OCT imaging system visualizes the ocular surfaces
Algorithms process the image, automatically and accurately maps surfaces and create safety zones
The surgeon’s treatment plan is then customized, based on the patient’s ocular anatomy and the precise orientation of the eye
After the surgeon confirms the customized treatment plan, the femtosecond laser pulses are delivered precisely to the intended location, maintaining the safety zones

Information on this page is taken from AMO website, http://www.abbottmedicaloptics.com/products/cataract/laser-cataract-surgery/catalys-laser-system

Wiki Femto Cataract

Astigmatism Correction at the Time of Cataract Surgery

Especially with advanced intraocular lenses that provide good vision without glasses after cataract surgery, it is important that the surgery results in minimal astigmatism. Examples of these advanced lenses are presbyopia-correcting multifocal IOLs and accommodating IOLs.

Basic-Information-about-Astigmatism1

Because astigmatism involves the cornea being more curved in one axis than the other (like a football shape), incisions can be used in the more curved axis to reduce the astigmatism so the cornea has a rounder shape (like a basketball). The procedure is called astigmatic keratotomy or AK.

Surgeons perform AK free-hand with a diamond blade, and it is quite effective in reducing astigmatism.

During refractive laser-assisted cataract surgery, the OCT image can be used to plan the AK incisions in a very precise location, length and depth, and then the laser accurately creates them. Since the laser minimizes the variables involved, the AK procedure becomes more accurate and reproducible.

A New Era in Cataract Surgery

An exciting aspect of laser cataract surgery is the concept of optimization — the continuous improvement of a technique or technology.

One example is the incision. When it is made with a human hand guiding a blade, there are limitations. But a laser can make a perfect zigzag incision that interlocks precisely and improves the chance of self-sealing, and this is an advancement over traditional manual technology.

Once a laser enters the surgical arena the opportunities to optimize are endless. We are just in the beginning of this refractive laser-assisted cataract surgery journey, and precision improvements will arrive quickly.

Conclusion

It is important to put this new technology into proper perspective. Traditional cataract surgery is very effective and successful. People who do not want to invest out-of-pocket money in laser cataract surgery can still feel confident about the traditional approach.

But for those who want the best possible vision, the laser approach is appealing. A more accurate incision, capsulotomy and astigmatic correction will help to achieve their goal of less dependence on glasses after cataract surgery.

Keep in mind that even though the early results of laser cataract surgery are promising, this is newer technology that deserves in-depth research and discussion with your doctor so that you can make the best possible decision for your situation

Why Laser Cataract

Source: http://www.allaboutvision.com/conditions/laser-cataract-surgery.htm

Videos of Bilateral FLACS

 

Bilateral FLACS seen through 360 GoPro Max, Hero 8 and the Microscope Camera

Single Eye FLACS/360 GoPro