Cataract can be age-related, but can also occur in a congenital form, as a result of a traumatic event, metabolic disease (e.g. diabetes), or certain medications (e.g. cortisone).

Today, the treatment consists of the surgical removal of the lens followed by the implantation of an intraocular lens (IOL). This surgery is among the top five most valuable health interventions in terms of effectiveness. However, in many countries, cataract remains the leading cause of blindness (WHO, 2010) due to inadequate health care services ().^–

Every year, 15 million cataract surgeries are performed worldwide, of which 3.5 million in the USA. Therefore, after childbirth, it is the most performed surgery in the world. This makes it obvious why particular attention is given to the continuous evolution of surgical techniques in order to reduce the intra- and postoperative risks for patients and to facilitate the intervention for the surgeons, so as to allow rapid functional recovery of sight.

The removal of the crystalline lens was already practiced in ancient Rome with the Reclinatio (Couching), which consisted of inserting an acute tool through the limbus and dislocating this “bad spirit” (cataract) downwards. The technique had not changed for millennia.

Only in the last fifty years have we seen a continuous and bustling evolution of this intervention due to advances in bioengineering and materials for the creation of sophisticated intraocular lenses. The use of the surgical microscope, of viscoelastic substances and phacoemulsifiers of the latest generation has reduced the length of recovery from 20–30 days in outpatient surgery. The intervention with smaller incisions has led to remarkable socioeconomic developments, thanks to the patient's immediate rehabilitation.^–

In recent years, the new concept of refractive cataract surgery has been outlined, whereas the quality as well as the quantity of sight is considered. In ophthalmology, just as in general medicine, robotic surgery is gaining field with excellent results. In fact, digital surgery represents, the last technological step to the highest precision and quality thanks to the application of femtosecond technology in cataract surgery. The purpose of this textbook is to describe the femtosecond laser surgery for cataract; to explain the treatment and underline the benefits of this type of digital computerized surgery, and to compare it with the traditional phacoemulsification, which represents the current gold standard. We will go through the five laser systems today in commerce. The authors, as pioneers of this surgical technique, are going to share their personal experience, giving advice for a successful surgery.