A panel of refractive surgeons praised the speed and precision of a newly approved femtosecond laser, the VisuMax 800 (Carl Zeiss Meditec), during an informational session at the ASCRS meeting in Boston this weekend. “The VisuMax 800 I believe is a game changer,” said John F. Doane, MD, ABO, who moderated the panel. “The photodisruption is fast enough to stay ahead of gas bubbles, and it is as focused as possible to get the best tissue dissection possible. Going from the 500 to the 800 is a totally different game.” In January 2024, the FDA approved the VisuMax 800 for use in the United States.
The ASCRS session, sponsored by Carl Zeiss Meditec, featured Dr. Doane and other panelists — including refractive surgeons Sanjay D. Goel, MD, ABO; Audrey R. Talley Rostov, MD; and William F. Wiley, MD, ABO. The surgeons noted that the VisuMax 800 is considerably more powerful than previous femtosecond lasers, with an increased pulse frequency of 2 MHz. This reduces the time to make lenticle cuts for the small incision lenticule extraction (SMILE) procedure from about 30 seconds to just 9 seconds; a flap can be made in about 5 seconds.
Dr. Wiley noted that the speed increase allows surgeons to complete a SMILE procedure about two-and-a-half minutes faster that previous models. “If I’m doing 10 patients in the morning and 10 patients in the afternoon, I’m saving 25 minutes, which is a lot of time,” he said. “That matters for practices that are really trying to be über-efficient with their staffing and their processes and getting patients through the door.”
The device is smaller than Zeiss’s previous lasers and comes with AI-powered systems to help surgeons control procedures. Dr. Talley Rostov provided slides and videos demonstrating CentraLign, a computer-controlled function that enables easy centration, as well as the OcuLign feature, a cyclotorsion adjustment. “This makes it really, really easy,” she said. “You do manual marks, and then once you dock, you see these three lines and if you need to align your marks for any cyclotorsion you don’t lose suction, and that works really well.”
Another system that comes with the VisuMax 800 is Visulyze, an all-in-one refractive data tool. It enables surgeons to collect and store refractive data then statistically analyze that data and create nomograms, which can help to optimize clinical results.
“As a cornea surgeon, I really appreciate the precision that the VisuMax achieves,” Dr. Rostov said. “When you look at the OCT you can see how precise and clean the VisuMax cuts. It’s really something to appreciate how cleanly it can cut the cornea.”