With a femtosecond laser it is possible to automate several of the key steps in cataract and refractive lens exchange. The laser can make the incisions, create a perfectly centred opening in the bag that holds the natural lens and then begin to soften the cataract or lens, within the bag making it easier to remove it. The laser procedure takes place in a separate room to the operating theatre. The process takes about 5 minutes and is done with the patient lying down. Once the laser is completed the patient sits up and walks to the operating theatre where the rest of the procedure is completed. The key advantage with femtoseccond laser cataract surgery is that having precisely completed the initial steps it makes the rest of the procedure easier for the surgeon. Mark Wilkins is principal investigator of a UK government-funded trial looking atthe benefits of femtophaco for patients having cataract surgery on the NHS. The trial will look at the outcomes, quality of life and healthcare economics of this new technology.