Description

The cataract affects the human cristalline lens with a decrease of transparency and increase of scattering, with an ultimate blinding outcome. Surgery of the cataract is the most widespread surgery, and 51% of world blindness is due to cataract (i.e 20 millions people).

The cataract surgery consists in removing the lens and replacing it with an intraocular implant. In order to remove the lens, many techniques were developped. Today, the use of a phacoemulsifer is standard. This handpiece allows for emulsification of the lens thanks to ultrasonic vibration of its metallic needle and aspiration of the debris through its tip. If the surgery is well-known, there is risk using the handheld phacoemulsifier that can perforate the posterior lens capsular bag. Nowadays, femtolaser laser pulses are used to perform a pre-cut pattern on the crystalline lens to ease the phacoemulsifier step. During this step that can be relatively long, the patient’s eye is docked. Here, it can be argued that the benefit brought by the femtosecond laser pulses is low compared to the eye-docking necessity, especially because the phacoemulsifier is still necessary.

We report here the use of an array of ultrafast laser spots to perform an entire photo-emulsification of the lens in a reduced time (FemtoMatrix ). 2D and 3D laser spots arrays are achieved in the focal plane of scanning optics using wavefront modulation. The density of irradiated planes is such that the cut debris are small enough (below 200 μm) to be directly removed with a regular thin irrigation-aspiration system. There, no phacoemulsifier is required. The start-up Keranova has recently successfully performed two in-human clinical study with more than 30 complete photoemulsification of human crystalline lens with no need of phacoemulsifier. The procedure lasts below 40 seconds during which more than 3 ×106 impacts are achieved in the volume of the cristalline lens for full photoemulsification.

We also present some results related to an in-situ cavitation detection feedback enabling to automatically adapt the laser treatment to the tissue.

Contributing Authors

  • Cyril Mauclair
    Keranova | Laboratoire Hubert Curien, Université Jean Monnet
  • A. Bernard
    Keranova
  • E. Baubeau
    Keranova
  • F. Romano
    Keranova
Cyril Mauclair
Keranova | Laboratoire Hubert Curien, Université Jean Monnet
Track: Frontiers in Laser Applications
Session: Biomedical Applications
Day of Week: Monday
Date/Time:
Location:

Keywords

  • Ophthalmic Surgery
  • Spatial Beam Shaping
  • Ultrafast Laser Pulses