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What is the Femtosecond Laser? by Shunai Jiang, M.D., Ph.D.

July 10, 2020

Dr. Jiang is an ophthalmologist, cataract surgeon, and glaucoma specialist at the Marietta Eye Clinic.

Cataract surgery is now safer and more effective than ever thanks to many advancements in technology. One of those advancements is laser-assisted surgery using a femtosecond laser. A femtosecond laser is an infrared laser that emits bursts of laser energy at an extremely fast rate. These lasers have a pulse duration of one quadrillionth of a second, also known as the femtosecond range. Although femtosecond lasers were originally introduced in ophthalmology for use in LASIK eye surgery, they have become widely used in a variety of eye surgeries and have become a preferred tool in many surgical eye procedures, including cataract surgery.

The History of the Femtosecond Laser

The femtosecond laser was first introduced in the early 1990s after being developed by Dr. Kurtz at the University of Michigan. It was approved in 2001 by the U.S. Food and Drug Administration for use in laser-assisted in situ keratomileusis, or LASIK eye surgery. Since then, the technology has improved further. Newer femtosecond lasers have an increased pulse frequency. Less energy is released so that less tissue surrounding the target area is affected. These models are more energy efficient than previously introduced models, and procedures can now be completed more quickly. Today, the femtosecond laser is used in a variety of ophthalmic surgeries, and advancements continue to be made.

How Does the Femtosecond Laser Work?

In laser-assisted surgery, tissue is broken apart at the molecular level rather than cut with a blade. The femtosecond laser disrupts stromal tissue through a process known as photoionization. Targeted tissue is vaporized, creating a split where a cut would normally be made with a blade.

What are the Benefits of Using a Femtosecond Laser?

Femtosecond lasers have been proven in studies to offer more precise incisions with less damage to the surrounding tissue compared to those made with a blade. Some studies show that femtosecond lasers, compared to blades, cause fewer complications and that patients heal faster post-surgery. A femtosecond laser also has the benefit of greater consistency and more versatility. Compared to an Yttrium-Aluminum Garnet (YAG) laser, another laser commonly used in eye surgery, a femtosecond laser causes less collateral damage — 106 times less damage, in fact. The unique properties of femtosecond lasers have led to many advances in surgical techniques as they have become more widely adopted.

The four most commonly used femtosecond lasers used in ophthalmology are:

  • Catalys
  • LenSx
  • LensAR
  • Victus

The Marietta Eye Clinic uses Catalys femtosecond lasers.

Which Procedures are Commonly Performed with Lasers?

After its initial development for use in refractive surgery, the femtosecond laser was approved for cataract surgery by the U.S. Food and Drug Administration in 2015. A femtosecond laser can also be used for other procedures.

Common procedures performed with femtosecond lasers include:

  • Small incision lenticule extraction (SMILE)
  • Penetrating keratoplasty (PKP)
  • Deep anterior lamellar keratoplasty (DALK)
  • Descemet’s stripping endothelial keratoplasty (DSEK)

Femtosecond lasers are some of the most advanced technology in ophthalmology at the moment. They have been shown to aid ophthalmologists in cataract surgery as well as many other ocular procedures. Talk with your eye surgeon about whether your procedure may benefit from laser technology.

More About Cataract Specialist Shunai Jiang, M.D., Ph.D.

Dr. Jiang is an ophthalmologist at the Marietta Eye Clinic who specializes in cataracts and glaucoma. She serves the Kennestone, Canton, and East Cobb locations. Dr. Jiang studied at Jilin University in China and the Karolinska Institute in Sweden, the home of the Nobel Prize in Physiology or Medicine. She received her residency training in ophthalmology from the University of Louisville and fellowship training in glaucoma from Emory University. She is a member of the American Academy of Ophthalmology and the American Glaucoma Society. Read her full bio here.

References and Additional Resources

The American Academy of Ophthalmology (AAO) is the world’s largest association of eye physicians and surgeons. It describes itself as a “global community of 32,000 medical doctors who protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public.” Its website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (AOA) describes itself as the leading authority on quality care and an advocate for our nation’s health, representing more than 44,000 doctors of optometry, optometric professionals, and optometry students.

FDA approves laser for refractive and cataract surgery

https://www.aao.org/headline/fda-approves-laser-refractive-cataract-surgery-2

Femtosecond lasers and laser assisted in situ keratomileusis (LASIK)

https://eyewiki.aao.org/Femtosecond_lasers_and_laser_assisted_in_situ_keratomileusis_(LASIK)

Femtosecond Cataract Surgery

https://eyewiki.org/Femtosecond_Cataract_Surgery

Femtosecond lasers and laser assisted in situ keratomileusis (LASIK)

https://eyewiki.aao.org/Femtosecond_lasers_and_laser_assisted_in_situ_keratomileusis_(LASIK)

The evolution of corneal and refractive surgery with the femtosecond laser

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655461/

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