Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS)

Chapter 1: Evolution of Cataract Surgery STEINERT AGARWAL o Crystalline Lens Removal (Couching to ICCE) o Intraocular Lens Insertion o ICCE to ECCE (importance of capsular bag IOL placement, safety) o ECCE to Phaco (visual rehab; astig control, UCVA outcomes, eventually safety) o Small Incision Lens Emulsification and Capsulorhexis o Foldable IOLs o Astigmatism control o Laser capsulotomy allowing easy mgt of PCO if lens in Bag-hence rise of rhexis o Small Incision Foldable and Premium Lens Insertion o In the bag centration o Intact rhexis to allow accommodating IOL function o ELP o Astig control (incision size, rotational accuracy of lens in bag) o Femtosecond laser cataract surgery o Rise and refinement of refractive cataract surgery x Importance of rhexis size, centration, shape o Historical paradigm of the success of lasers in keratorefractive surgery o Marriage of imaging technology with laser delivery systems-use lasers to do as much as possible for improved precision and safety. Chapter 2: Femtosecond Laser Fundamentals LUBATSCHOWSKI PALANKER o Engineering fundamentals of Lasers o Basics of Laser-tissue interaction and Femtosecond Laser peculiarities o Overview of Femtosecond Laser use in ophthalmology Chapter 3: Challenges of Femtosecond Laser Technology for cataract surgery x Engineering/technical * Hardware * Software * Imaging * Image processing x Clinical * Pt interface/ergonomics * Workflow/ergonomics/time/personnel * QA/Safety * Breadth of capabilities x Economic * Acquisition, maintenance, and variable costs * Integration of costs in current economic models of cat sx Chapter 4: Imaging and patient interface systems TALAMO & KRUEGER o Clinical Significance o Modalities o Techniques x OCT x CSI/SCHEIMPHLUG x VIDEO x INTERFACE APPROACHES * PATIENT SAFETY * PATIENT COMFORT * IMAGE RESOLUTION/PRECISION o Resolution and Limitations Chapter 5: Capsulotomy KOCH - OPTIMEDICA STEINERT-LENSX NICHAMIN-LENSAR o Size o Shape/Circularity o Centration o Strength Chapter 6: Nucleus Disassembly o KRUEGER & OTHER? o Fragmentation o Softening o Approaches for different nuclear densities o Technical safeguards Chapter 7: Corneal Incisions CULBERTSON & YOO SEIBEL & KOCH? o Principle incision o Paracenteses o Astigmatic Incisions o Femtosecond vs. AK vs. LRI vs. Excimer vs. Toric IOL Chapter 8: Femtosecond laser versus phacoemulsification OSHER & NAGY o Indications/contraindications for laser cataract surgery o Advantages/Disadvantages o What we know and what we don't! Chapter 9: Economics of laser cataract surgery LINDSTROM o Cost/Benefit ratio -- uses in the developing world, teaching etc! o Possible Economic Models o Fuel for Technological Advancement Chapters 10-14: Commercially available systems (WITH MD'S) o Alcon/LensX WEINBERG/SLADE o LensAR FREY o Optimedica FORCHETTE o Technolas HOHLA