Unnecessary gadget. Expensive toy. Purely a marketing tool for your practice. These are a few of the phrases that I’ve heard used to describe femtosecond lasers, coined because there’s no evidence that femtosecond lasers achieve better optical outcomes than manual surgery. But I think there’s a general feeling that the age of femtosecond lasers is inevitable. Costs will fall, the capabilities will improve, the process will become faster, and eventually, post-surgical optical outcomes will be better than by hand. But that hasn’t happened so far so many surgeons feel that there’s no truly compelling reason to buy one… yet.
Perhaps what the femtosecond laser market needs is its own VisiCalc. Let me explain. In the 1980s, microcomputers were expensive toys – cool, not that useful, but somehow the future. Before the IBM PC, the Apple II was the dominant computer. In 1980 it cost US$2000 (US$5,750 in today’s money), and initially, sales were low. Then VisiCalc, the first spreadsheet available on a microcomputer appeared. People instantly saw how useful it was. They needed it. And it was only available on the Apple II. This “killer app” made Apple II sales skyrocket – and was the making of Apple. We await that first femtosecond laser killer app. I wonder if Laser Bridge astigmatic keratotomy ("Is this Femto’s Killer App?") is it. So far, its utility has been demonstrated only in computer simulations, but it exploits everything that a femtosecond laser has to offer – variable incision depth and ablation widths – capabilities that the human hand would struggle to (or cannot) achieve.
Spreadsheets are no longer a killer app. Their introduction did transform our ability to perform data analyses, but crucially, only if the data was entered in the right way. Natural language information analysis is the next data analysis frontier; it means that you could throw any old document at a big data analytics machine and get a cogent analysis in return. Not so much a killer app, as a game-changer: just imagine what it could do with written medical records! Pete Sudbury, a UK-based NHS consultant who’s currently on secondment at HP’s Enterprise Services division, has a unique perspective on what big data can do for medicine and ophthalmology. He shares his view of the future in "Big Data". Now, when do I get my flying car?
