Femtosecond pretreatment appears safe, well-tolerated in cataract patients

This prospective study found that femtosecond laser treatment before cataract surgery using the Catalys Precision Laser System was associated with a small and transient increase in IOP.

The authors evaluated in vivo IOP rise in 25 patients (25 eyes) undergoing femtosecond pretreatment. The mean patient age was 72.5 years.

The mean rise in IOP was 18.5 ± 4.7 mmHg and was well tolerated without complications. The maximum IOP in this study was significantly below the mean arterial pressure, and there were no cases of amaurosis during the procedure. Petechial and subconjunctival hemorrhages were infrequent. There were no IOP-related complications, and the authors note that there are no published reports of IOP-related complications during or after femtosecond laser pretreatment.

There was a mean IOP rise of 11.4 mmHg during the vacuum phase. The authors say this is significantly less than the IOP rise described with other docking systems used for refractive surgery. One study of human cadaver eyes reported a mean IOP increase of 78.3 mmHg after application of the suction ring during LASIK.

IOP rose further after capsulotomy and lens fragmentation but decreased with removal of the suction ring, although it remained above presurgery levels. There was no relationship between IOP rise and any variable measured. Even with prolonged vacuum time of greater than six minutes, there was no additional increase in peak IOP.

The authors conclude that further research is needed to increase our knowledge about the effects of IOP changes during femtosecond laser pretreatment, particularly in patients with ocular disease.