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Adaptive optics has emerged as an empowering technology for retinal imaging with cellular resolution. This technology holds potential for non-invasive detection and diagnoses of the most common eye diseases such as glaucoma, diabetic retinopathy and age-related macular degeneration (AMD). However, the cost and complexity of adaptive optics ophthalmoscopes currently impede its clinical use. A scanning laser ophthalmoscope with phase plate has the potential to establish adaptive optics in a clinical application by simplifying its incorporation in the prevailing systems. Phase plates can correct aberrations down to diffraction limit and can be easily incorporated into ophthalmoscopes to improve the retinal image quality.

More than 25 years ago, the first in vivo measurement of the eye’s wave aberration was demonstrated at the University of Heidelberg, using the Shack-Hartmann method. The continuous measurement of ocular aberrations paved the way to employ adaptive optics for the correction of ocular aberrations in ophthalmoscopy. Various new diagnostic and treatment modalities have since been successfully introduced, e.g. adaptive optics scanning laser ophthalmoscopy (AO-SLO), adaptive optics optical coherence tomography (AO-OCT) and adaptive optics two-photon ophthalmoscopy (AO-TPO). Employing adaptive optics techniques, the limits of human vision can be assessed. With the development of wavefront-guided laser refractive surgery, the quest for optically perfect vision is being pursued over the last 20 years.

Cataract surgeons are in constant pursuit to achieve optimal visual outcomes for their patients. Therefore, numerous technologies and techniques have emerged, most of which are designed to assist the surgeon preoperatively and intraoperatively. The in vivo modification is achieved by creating a lens within an existing IOL using a femtosecond laser. The lens within the lens is created by altering the hydrophilicity of an existing and standard IOL in certain designated areas. The changes created by the perfect lens technology alter the IOL’s refractive outcome and enable the surgeon to create the patient’s desired vision in a simple postoperative in-office procedure.

Femtosecond-Laser-Assisted cataract surgery (FLACS) offers surgeons a reproducible, non-invasive technique to replace the least predictable and technically most demanding steps of conventional cataract procedures. A computer-guided laser linked to an optical imaging system (e.g. OCT) performs the corneal incision, capsulotomy, and lens fragmentation steps, thus changing the requirements associated with traditional techniques by removing the need for blade incisions and reducing phacoemulsification time and energy. Initial research has confirmed appropriate safety and efficacy of Femtosecond-Laser-Assisted cataract surgery, with improvements in anterior capsulotomy, phacofragmentation, and corneal incision. The potential gains in precision associated with FLACS may improve safety and clinical outcomes.