Dr. Scott Greenstein, a comprehensive ophthalmology and cataracts expert at Massachusetts Eye and Ear Infirmary, said he was uneasy that the research was funded by a company with a stake in the outcome. But he added that the data was encouraging.
"I personally am excited by it," said Greenstein, who teaches ophthalmology at Harvard Medical School. "It's an enhancement of something we're already doing that's quite successful."
"We need a number of centers studying this with more patients," he added. "It would be useful to see if there is a significant statistical difference in the outcomes."
Both Greenstein and Dr. Richard Bensinger, a Seattle ophthalmologist and spokesman for the American Academy of Ophthalmology, expressed concern that the laser-guided cataract surgery would be much more expensive than manual surgery and were skeptical that health insurance companies would be willing to pick up the tab.
"It's a fairly expensive way to do something we do right now with a $120 instrument that makes the opening," Bensinger said. "It's beneficial to the extent that it can avoid a tear [in the cornea] . . . but the downside is you need a very expensive machine to do it. It's at best a little refinement that adds a little precision."
Although the femtosecond laser technique is unquestionably more precise, Palanker's claim that it results in a better fit for the artificial lens replacing the clouded one is dubious, Bensinger and Greenstein said. Experienced surgeons performing manual cataract surgery rarely have trouble aligning the new lens with the pupil and keeping it in place, they noted.
"Over the thousands of cases I've done, I'm really not aware personally of this being a problem," Greenstein said. "If you have a less precise, experienced surgeon then this would be a benefit for the patient. It makes reproducible, perfect incisions every time."
Palanker said further research will focus on whe
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