- 17 Sep, 2024
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Laser Cataract Course 2025
Laser Cataract Course
Cataract surgery is a procedure performed to remove a cloudy lens in the eye
that has become discolored or opaque, which is known as a cataract.
The procedure has evolved from one that used to take over an hour; to a procedure
that now takes just 20-30 minutes or less, and patients can leave the hospital
on the same day with no need for sutures or stitches.
Modern technology has been the driving force behind making the procedure safer,
and quicker, so it needs training on.
The Laser Cataract Course Focuses on:
– The modern state of this evolving field, and the different uses for laser technology.
– The latest advancements and techniques in preoperative evaluation
– The surgical techniques employed by the different laser platforms, the unique features and pitfalls of each.
– Postoperative management and complications
By the end of the laser cataract course, the surgeon will have a thorough appreciation
of the broad potential of using lasers in cataract surgery and a deep understanding of how modern
laser techniques can be applied to achieve the best outcomes for patients.
What the Surgeon Needs During the Laser Cataract Course
1- Overview of the Laser Cataract Course
One of the most common surgeries in the world today, the removal of the hazy natural lens
from the eye, known as cataract surgery, is an ever-evolving and vibrant
subspecialty in the field of ophthalmology.
The traditional cataract surgery When a manual incision is made,
the wounds rely on the patient’s natural healing process,
which is variable and often leads to poor wound construction and an unstable ocular surface.
A relatively new technique in cataract surgery incorporates the use of a femtosecond laser.
This type of laser uses near-infrared light that can make very fine and precise cuts in a variety
of tissues within the eye, including the cornea, lens, and corneal incision.
The laser uses very short and quick pulses and can be positioned accurately,
reducing collateral tissue damage.
This technology allows surgeons to plan and perform incisions, astigmatism correction,
and capsulotomy with enhanced precision.
Through the laser cataract course, will train on this technology.
2- Presentation Evolution of Laser Technology in Cataract Surgery
lasers are not used to remove the cataract itself from the eye; the laser and its associated
technology are used to perform key parts of the preparation for the cataract’s removal,
such as creating the incisions in the cornea and the circular hole in the capsular
bag through which the clouded lens will be removed
The use of a laser to perform these steps offers the potential for greater accuracy
than the traditional methods of creating these incisions – the laser can be directed
to create incisions to fractions of a millimeter, and it has also been found to be able to create reproducible,
precisely sized and accurately positioned incisions with a much higher degree
of certainty compared to those performed manually.
The key concept behind laser-assisted cataract surgery, as well as the other types
of modern cataract surgery, is to use lasers and technology to minimize the manual parts of the procedure.
The expected benefits of laser cataract surgery include greater precision in performing
the key steps listed above.
Just as with computer-guided laser eye surgery and the most modern forms of cataract surgery,
this tailored approach has the potential for improved visual outcomes and reduced risk
of complications compared to the traditional ‘one size fits all’ manual cataract removal procedure.
The nineties saw vast improvements in the technology and technique of cataract surgery
on a couple of fronts. On the one hand, phacoemulsification, or ‘phaco’,
revolutionized the way cataract surgery was performed.
Phacoemulsification uses ultrasonic energy to emulsify or break up the cataract,
and then vacuum the pieces out of the eye through a small incision.
The surgeon inserts a tiny probe into the eye that emits the ultrasound waves
which soften and then break up the clouded lens.
This process allows for a much smaller incision, usually around 3mm or less,
and is considered a ‘minimally invasive’ procedure.
The small incision size often allows the eye to heal more rapidly, less astigmatism is induced,
and it also often means that a suture isn’t required to seal the incision.
This type of surgery quickly became the most common and successful method for cataract
extraction around the world and is what most people would consider to be ‘modern’ cataract surgery.
3- Laser Cataract Surgery in Wet-Lab
laser cataract course in the use of femtosecond laser surgery and its ancillary diagnostics
in a live wet-lab environment accessed using a surgeon simulator could be extremely useful.
Wet-lab-based medical-surgical education has become part of the surgical training.
The purpose of training in the wet lab is to provide an environment similar to the human
body so that students can perform, practice, and experience various surgical techniques
on animal organs in the wet lab rather than on patients.
surgeons learn basic wound writing, tissue handling, and also how to control bleeding by coagulation in a wet lab.
The purpose of training in a wet lab is to provide an environment similar to the human
body so that students can perform, practice, and experience various surgical techniques
on animal organs in a wet lab rather than on the patient.
Also, students can learn basic wound writing, tissue handling,
and how to control bleeding by coagulation in the wet lab.
Benefits of Wet-Lab Training
Lastly, the wet lab at the laser cataract course encourages team building and collaboration
among surgeons from different areas.
It offers a platform for sharing knowledge and experiences among colleagues
and for fostering innovation in surgical techniques.
By building up the skill set of more surgeons, particularly those who have been experienced
with traditional cataract surgery but are new to laser technology,
wet lab training could help expedite the broader adoption of laser cataract surgery and ultimately benefit more patients.
Another advantage of wet lab training is the ability to learn the necessary skills in a controlled environment.
This is particularly important for new surgeons starting to perform laser cataract procedures.
A wet lab setup provides an ideal space to become familiar with the different stages of the surgery
and to build up the required level of competency.
Unlike traditional learning on patients in the operating room, wet lab training allows surgeons
to ask for help and receive immediate feedback from experienced trainers.
Such an interactive learning experience would help minimize errors that can compromise
safety and improve the learning curve.
One major benefit of wet lab training is the ability to practice using laser cataract surgery instruments.
Laser cataract surgery involves using a femtosecond laser to perform corneal incisions,
anterior capsulotomy, and fragmentation of the cataractous lens.
The laser system is equipped with an integrated three-dimensional optical coherence tomography
(OCT) imaging system, which provides high-resolution, real-time imaging of the anterior ocular surface,
guiding precise laser delivery and ensuring safety.
In addition, femtosecond laser capsulotomy is more accurate and reproducible
in terms of achieving circular and well-centered capsular openings,
compared to manual continuous curvilinear capsulorrhexis.
Without wet lab training, surgeons may not have the chance to familiarize
themselves with the steps of the surgery, the technology involved,
and potential complications that may arise intraoperatively.
4- Laser Cataract Surgery Techniques
The laser cataract surgery techniques section is the most extensive one of the entire course.
The first topic is about femtosecond laser technology.
The instructor, during the laser cataract course, explains the principle of femtosecond laser-tissue
interaction and the safety and efficacy of femtosecond laser in anterior capsulotomy and corneal incision.
– Capsulotomy Creation
Regarding the lens caps, one is to develop a continuous circular capsulotomy,
a critical step in the safe and efficient removal of the cataractous lens.
The necessity for precision in continuous curvilinear capsulotomy is well understood.
Current methods of capsulotomy require the surgeon to use a continuous tear technique
after an initial partial cut has been made, commonly referred to as a “can-opener” technique.
During the laser cataract course, the surgeon will learn the initiate the tear in the appropriate
axis and develop a continuous curvilinear tear while maintaining a careful and steady trajectory.
The laser creates the initial opening in the anterior lens capsule and then photodisruptive
energy is used to create the capsular cleavage from the anterior capsule to the initial opening.
– Lens Fragmentation
When the laser arrives at the desired depth, the lens fragmentation process starts.
With femtosecond laser technology, the steps of lens fragmentation include creating the initial trench,
followed by additional fragmentation, and finally softening the posterior.
This is all conducted within the patient’s eye, without any need for the surgeon to manually
enter the eye for lens fragmentation. Once lens fragmentation is completed, a well-defined dissection plane between the soft lens material and the epinucleus is achieved.
Work could then begin on breaking the trench to the point where individual lens
sections can be maneuvered and removed.
In the subsequent steps, ultrasonic energy, such as that produced by the phacoemulsification handpiece,
is used to emulsify and remove lens material.
Postoperative Management
Postoperative management begins immediately after surgery with the patient’s first visit.
Patients should be seen the day following the surgery, and seen again at the one week and the one month.
The laser cataract course not only focuses on the surgical experience but the postoperative period as well.
Major immediate postoperative adverse events like infection and endophthalmitis are very rare.
The majority of the patients can see well within a few hours after the surgery.
They are advised to go home and take a good rest.
However, before they leave, all patients must be examined by the operating surgeon.
Checking vision and pressure within the eye is very important.
The patients must be advised to avoid rubbing the eye and pushing or pressing on the operated eye.
No bending at the waist and lifting heavy objects should be done in the postoperative period.
This is to prevent any bleeding and pressure rise in the eye.
These instructions together with the explanation about the surgery, implant lenses, risks,
and benefits should be given to the patient and also despite the best endeavor of the surgeon
and the patient to achieve the best possible outcomes
Patients are often prescribed a variety of eye drops after surgery,
most of which are designed to minimize the risk of infection and reduce inflammation as the eye heals.
For this reason, the course emphasizes the importance of patient education in the postoperative care process.
Purpose and Scope of the Laser Cataract Course
The purpose of the laser cataract course in MoAcademy is to provide an in-depth understanding
of the latest advancements in laser cataract surgery techniques.
The course covers various key aspects of cataract surgery including pre-operative assessment,
advanced technology in cataract surgery including the use of the femtosecond laser,
and the latest techniques of cataract surgery.