Cataract surgery with a mid-infrared endo-laser system

With most current cataract surgery techniques, an intraocular lens (IOL) is implanted in the capsular bag to emetropize the eye for distance vision. Modern IOLs are made of flexible materials (e.g., silicone and acrylic elastomers) allowing the surgeon to fold and insert the IOL through a smaller limbal incision (4 mm), thus reducing the number of sutures. When using a scleral pocket technique, suturing of such small wounds might not be required. Recently, IOLs having 2 foci (multifocal IOLs) have been introduced. These implants give the patient a second focal plane at normal reading distance, but the double image reduces both visual acuity and contrast sensitivity. However, with all present surgical techniques, the patient loses the natural ability to accommodate. By directing laser energy into a flexible fiber, cataract removal might be performed endoscopically while minimizing trauma to healthy tissue. Bath successfully demonstrated the use of the 308 nm XeCl excimer laser for cataract removal. A significant drawback, however, lies in the fluorescence induced by the 308 nm laser pulses which may cause significant retinal damage. The use of UV radiation also raises serious concerns about carcinogenesis and cataractogenesis risk to both the patient and the surgeon.