Origins of CAPSULASER

CAPSULASER was invented by Dr. David Mordaunt and has been refined by many skilled and talented cataract surgeons with major contributions from Drs. Pavel Stodulka and Richard Packard. CAPSULASER is based on David’s experience in working with ophthalmologist to advance the standard of care with SLT, Pattern Scanning Photocoagulators (PACAL), Retinal PDT Visudye, and Femtosecond Laser Assisted Cataract Surgery (FLACS). For details please read below.

David’s academic journey began with research in molecular dynamics and laser spectroscopy at UC Berkeley and the Max Planck Institute, which revealed the potential of lasers and dyes to atmospheric and medical applications. This experience led him, in 1998, to a career specializing in medical laser systems, which were then based on traditional laser-tissue interactions. He founded Optimedica in 2004, focusing on the use of scanned lasers within the eye. Ophthalmology greatly appeals to laser experts because the eye’s transparency allows lasers to be easily delivered to key regions, treating many conditions. While developing FLACS in the lab, David noticed inherent limitations compared to traditional capsulorhexis. Interestingly, David holds the most patents for FLACS. Despite this legacy, he believed there had to be a better way, leading to the development of CAPULASER.

The highest resolution translational spectra recorded in history

MAD H-Atom Spectroscopy Laser Lab 1992

(MAD = Mordaunt, Ashfold & Dixon era)

The highest resolution translational spectra recorded in history

Mordaunt et al. Near Threshold Photodissociation of Acetylene, J. Chem. Phys. 108, 519–526 (1998)

Why the new field of Dye-Enhanced Laser-Tissue Interactions?

David’s family name, “Mordaunt,” traces its roots back to the Roman era invention of the acidic Mordaunt agent (Latin for acidic biting = Mordaunt). This agent revolutionized the world over the last two millennia by allowing dyes to permanently color fabrics. Inspired by his heritage and with his scientific research in lasers and dyes, David devised a method to selectively color the transparent anterior capsule with a dye, then use a continuous laser absorbed by this dye to create a capsulotomy. This is the first instance of Dye-Enhanced Laser Tissue Interactions; the pipeline is strong with other inventions ranging from dermatology to surgical oncology.

How to obtain a laser-tissue interaction of a clear membrane? Two-ways:

1.Micromachine of the tissue with photodisruption (i.e., FLACS which is micro-can-opener technique)

2.Apply the dye, transforms the transparent tissue, to a highly light-absorbing, then apply a focused laser that is absorbed by the dye-stained tissue, and achieve thermal separation of tissue (i.e., selective laser capsulotomy, which is laser parallel to CCC).

To test the concept, David took the plastic film wrap from his sandwich, colored it with black ink, suspended it on a PASCAL slit lamp, and, using a micromanipulator hand-drew a circle with a continuous photocoagulator, creating a precise opening—the CAPSULASER Eureka moment. After researching numerous dyes and lasers, David and Tom chose Trypan blue for its exceptional safety record and effectiveness in staining the anterior capsule.

The trends in going from first to second generation technologies are: smaller, faster and more cost effective

Ultimately, a custom laser specifically designed for the peak absorption of the anterior capsule temporarily dyed with Trypan blue was engineered. This was achieved using a quantum-dot thin-disc solid-state diode-pumped laser, which allowed the creation of a custom orange wavelength. Thus, CAPSULASER was born.

Finally, recognizing that commercially available dyes were inconsistent in their dying, David developed a proprietary formulation called CAPSULBLUE.

Just as Charles Kelman’s work on phacoemulsification took nearly 15 years of optimization before commercialization, the development of CAPSULASER followed a similar trajectory. Patience and refinement are often essential in bringing ground-breaking medical technologies to fruition.

Over past 25 years, David Mordaunt has been at the forefront of innovation in ophthalmic lasers and dyes. He has contributed to the design of over 200 medical devices. Most notably, David has collaborated with surgeons to develop eight new laser therapies and technologies, advancing the standard of care in ophthalmology, plastic surgery, and urology. David has personally assisted in transforming these eight medical applications:

David is pioneered and establish this new field of Dye-Enhanced Laser-Tissue Interaction with CAPSULASER¹.
Link to this video www.youtube.com/watch?v=4nZqDLA6Vbo
A detailed understanding of the ophthalmic dyes, has led David to develop the highest-purity surgically optimized ophthalmic Trypan blue solution for cataract surgery, CAPSULBlue². Nature has given us an additional benefit with this optimized dyeing process: the Trypan Capsular Landmark accurately identifies the central visual axis in the plane of the anterior capsule³.

Surgically optimized ophthalmic Trypan blue solution by Capsulaser

1. David is pioneered and establish this new field of Dye-Enhanced Laser-Tissue Interaction with CAPSULASER¹.

Link to this video www.youtube.com/watch?v=4nZqDLA6Vbo

2. A detailed understanding of the ophthalmic dyes, has led David to develop the highest-purity surgically optimized ophthalmic Trypan blue solution for cataract surgery, CAPSULBlue². Nature has given us an additional benefit with this optimized dyeing process: the Trypan Capsular Landmark accurately identifies the central visual axis in the plane of the anterior capsule³.

3 & 4. David was the founder of Optimedica, and along with Dan Palanker (Professor Ophthalmology Stanford) and Mark Blumenkranz (Former Chair of Stanford Ophthalmology) they invented Femtosecond Laser Assisted Cataract Surgery (FLACS)⁴ and Pattern Scanning Laser (PASCAL) for the treatment of Diabetic Retinopathy and other retinal conditions⁵.

5. David, as the VP of R&D at Coherent and Lumenis, invented a proprietary ultra-stable nanosecond laser cavity and led the engineering team that developed the origical Selective Laser Trabeculoplasty SLT laser devices back in the 2000s. He collaborated with Professor Mark Latina (Tufts) and achieved FDA clearance for (SLT) for the treatment of Open Angle Glaucoma⁶. Tom Liolios (EXCEL-LENS President) was VP of Marketing at Coherent and Lumenis and he launched SLT.

Selective Laser Trabeculoplasty - SLT Laser devices

6. At PrecisionLIGHT the second company David founded, he worked with key opinion leaders in Plastics surgery and invented of 4D imaging, preoperative planning and predictive outcome simulation for Plastic Surgery and use in reconstructive surgery⁷. This was the first use of AI in medical devices and David has given keynote presentations on AI at several international congresses.

The figure shows the current market leader in 4D Imaging using PrecisionLight Technology.

Predictive outcome simulation for Plastic Surgery and use in reconstructive surgery

7 & 8. One of David’s first medical laser project was to innovate and optimize the Holmium laser with a new laser crystal CrThHo:YAG (CTH), then led the engineer team in development of the first CTH laser system, fibers, clinical application and FDA clearance for Holmium Laser Lithotripsy for the treatment of Kidney Stones and Benign Prostatic Hyperplasia.

The photos highlight the bubble formation with the Holmium laser in saline solution and the resultant mechanical shockwave that results when this bubble collapses – i.e., photodisruption.

References

¹D Mordaunt. Laser assisted thermal separation of tissue. US Patent 8,562,596, D Mordaunt.

²D Mordaunt Preferred Anterior Capsulotomy location provided by trypan blue ophthalmic solution US2022362410 and associated patents.

³DV Palanker, MS Blumenkranz, D. Andersen, DH Mordaunt. Apparatus for Patterned Plasma-Mediated Laser Trephination of the lens capsule and three dimensional phaco-segmentation. US Patent 8,690,862 and associated patents.

⁴MS Blumenkranz, D Yellachich, DE Andersen, MW Wiltberger, D Mordaunt, GR Marcellino,D Palanker. Semiautomated patterned scanning laser for retinal photocoagulation. Retina. 2006; 26(3): 370-6. D Mordaunt et al. US1,0179,071 and associated patents.

⁵D Mordaunt et al. System, Method, and Apparatus to Provide Laser Beams of Two or More Wavelengths US2007230520

⁶Takusagawa HL, Hoguet A, Sit AJ, et al. Selective laser trabeculoplasty for the treatment of glaucoma: a report by the American Academy of Ophthalmology. Ophthalmology. 2024; 131(1): 37-47

⁷CN Creasman, D Mordaunt, TLiolios, C Chiu, A Gabriel ,GP Maxwell. Four-dimensional breast imaging, part I: introduction of a technology-driven, evidence-based approach to breast augmentation planning. Aesthetic Surgury J. 2011 Nov; 31(8): 914-24. Four-dimensional breast imaging, part II: clinical implementation and validation of a computer imaging system for breast augmentation planning. Aesthet Surg J. 2011 Nov; 31(8): 925-38. D Mordaunt and GP Maxwell, Anatomical recognition and dimensional analysis of breast volume to assist breast surgery US2011295112 and associated patents.

MAD H-Atom Spectroscopy Laser Lab 1992

The highest resolution translational spectra recorded in history

Why the new field of Dye-Enhanced Laser-Tissue Interactions?

The trends in going from first to second generation technologies are: smaller, faster and more cost effective

References

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