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Cataract The LenSx Laser—A Review of Current Literature on its Use in Cataract Surgery John Davidson, MD Assistant Clinical Professor, Stein Eye Institute, UCLA School of Medicine, Los Angeles, CA, US Abstract Laser cataract surgery (LCS) offers several surgical advantages over manual cataract surgery: the laser fragments the lens and creates corneal incisions and capsulotomies with a level of precision, control and reproducibility unachievable with manual techniques. The literature continues to expand and demonstrate many of the surgical benefits of LCS. There are important distinctions among the various femtosecond laser platforms that affect surgical technique. This review consolidates, organizes, and summarizes key published literature on the LenSx ® Laser. Keywords Laser cataract surgery, LenSx ® Laser, femtosecond laser technology Disclosure: John Davidson, MD, is a paid consultant to Alcon. Acknowledgements: Medical writing assistance was provided by Michelle Dalton and Bryan Bechtal for Touch Medical Media, funded by Alcon. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Received: October 9, 2015 Accepted: November 5, 2015 Citation: US Ophthalmic Review, 2016;9(1):16–20 Correspondence: John Davidson, MD, 3085 Loma Vista Road, Ventura, CA 93003, US. E: doctorjohn@johndavidsonmd.com Support: Alcon sponsored the publication of this promotional piece. John Davidson, MD, received compensation from Alcon for his contributions to this publication. The content has been independently peer reviewed and verified by the US Ophthalmic Review publication process. Several factors point to a potentially precipitous rise in the need for cataract surgery in the near future: population growth, increased awareness of and demand for excellent unaided vision, and the collateral benefits of improved vision after surgery. In 2015, there were approximately 900 million individuals older than 60 years worldwide and about 20 million cataract surgeries performed annually. 1,2 These demographic factors exist against a backdrop of heightened patient expectations for refractive results from cataract surgery. Older individuals are leading increasingly active lifestyles and will require greater functional vision to meet their lifestyle demands. Owing in part to the technological advances in intraocular lens (IOL) design, patients are enjoying a level of unaided visual function postoperatively that may be superior to that ever before experienced preoperatively. Cataract surgery benefits patients beyond improved vision, including a decrease in falls and improvements in general physical, cognitive, and emotional wellbeing. 3 In the US, femtosecond laser technology during cataract surgery is approved to create corneal incisions, perform the capsulotomy, and fragment the lens. 4,5 LCS has gained acceptance largely due to its perceived benefits compared to manual techniques: greater precision in the surgical steps and increased consistency. Published studies indicate LCS may be associated with greater accuracy of IOL power calculations, leading to greater predictability in refractive outcomes due to precise capsulotomy sizing and centering of the IOL. 6,7 In addition to the growing body of literature that suggests LCS has certain advantages over manual techniques, several published studies highlight important differences among the commercially available laser platforms. This review discusses state-of-the-art LCS technologies, how they differ from manual techniques and between platforms, and how this growing sector of LCS will continue to meet the demands of cataract surgery. Laser Cataract Surgery—Defining the Principle There are five femtosecond laser platforms approved for use during cataract surgery: LenSx ® Laser (Alcon); Catalys* (AMO); LENSAR* (LENSAR Inc); Victus* (Bausch & Lomb); and FEMTO LDV Z8* (Ziemer Ophthalmic Systems AG). Each platform incorporates anterior segment imaging, a patient interface (PI), and a femtosecond laser. Key differentiating factors, particularly in the interface systems and fixed or variable aperture designs, have implications in surgical performance. Some platforms use a liquid optic interface while others use a soft hydrogel interface, which have differences in fixating the eye during the procedure. Also, some have a fixed bed with a fixed Important Product Information about the LenSx ® Laser can be found on page 20 16 *Trademarks are property of their respective owners TOUCH ME D ICA L ME D IA