By Dr. Mark S. Siegel
Traditional or manual cataract surgery is one of the most common, safe and effective surgeries performed today.
The result of the surgery depends heavily on the surgeon’s skill and experience.
In manual cataract surgery, the surgeon uses a hand-held blade made of metal or diamond to create an incision in the cornea. A needle is then used to open up the cataract in a step called the capsulotomy. The surgeon can then break up the cataract using ultrasound and remove it, before inserting an intraocular lens (IOL).
Laser-assisted cataract surgery uses a femtosecond laser to remove cataracts accurately and precisely, replacing the use of handmade incisions.
The surgeon customizes a specific surgical plan with a 3-D image of the eye called OCT (optical coherence tomography). This innovative procedure used for cataract removal has been successfully performed for the past few years. With the specifications for location, depth and length in all planes, the femtosecond laser can perform the cataract removal with micro-level precision.
Benefits of laser-assisted surgery
There are many benefits to using femtosecond laser instead of conventional, manual cataract surgery. Laser-assisted cataract surgery is:
• Accurate: With the delicacy of eye surgery, even the smallest variation can create sharper vision. Laser-assisted cataract surgery introduces a new level of sophistication for preparing the eye for surgery and for performing the surgery itself. Computerized mapping and 3-D measurements give exact specifications for the procedure to achieve precise results. During the surgery, real-time visualization helps guide your surgeon for accurate incision placement.
• Bladeless: You may be hesitant about having eye surgery, and you are not alone. Laser-assisted cataract surgery is a minimally invasive procedure and offers computer-guided control when making the incisions and breaking up the cataract. This innovative technology provides efficient and effective treatment for cataracts without using a traditional blade. Lasers offer a new level of accuracy to restore ideal vision quickly.
• Customizable: Your eye is unique to you, and laser-assisted cataract surgery designs a plan specific to your own eye map. Computerized planning removes any guesswork from the procedure, and this delivers meticulous results. Your eye is thoroughly scanned for measurements, and the data is translated into a restorative, personalized plan that is custom-built for you. Laser-assisted cataract surgery also has individualized capabilities for treating astigmatism.
• Gentle: When the femtosecond laser is used to break up the cataract into small pieces, during a process called fragmentation, the subsequent amount of ultrasound energy required is significantly reduced. In my experience using the LenSx system, I’ve found a 50 percent reduction in my cumulative deposited energy levels. This reduced energy leads to clearer corneas, less stress on the eye, which translates into better vision sooner after your surgery.
What to expect before surgery
Laser-assisted cataract surgery requires detailed planning. Your surgeon will consider the anatomy of your eye and assess the pupil diameter, anterior chamber depth and the thickness of the lens and the cornea. Then, the type of lens fragmentation must be chosen. Parameters for the location, structure and depth of the corneal incisions are entered. When all data is stored, you are ready for surgery.
Your surgeon will also review your current medications and advise you of any changes that should be made either before or after surgery.
What happens during surgery?
Your eye must be docked into the laser platform to stabilize it. Next is a process called visualization, which involves 3-D, high resolution, wide-field imaging. Now, the laser procedure is ready to begin. Your surgeon will initiate the laser to perform the incisions with pre-set specifications. The laser then softens the cataract and breaks the lens into small pieces.
The surgeon then removes the deteriorated lens and implants the IOL, which will restore clear vision again.
What happens after surgery?
Recovery after cataract surgery is usually very quick, and most patients notice clearer vision within 24 hours of the procedure. Here are a few symptoms that are common after laser-assisted cataract surgery: itching, mild discomfort, tearing and sensitivity to light and touch.
Your doctor will prescribe anti-inflammatory eye drops to reduce inflammation and antibiotic eye drops to reduce the risk of infection, and you will have to wear an eye shield or eyeglasses to protect your eye. It is important to avoid rubbing or pressing on your eye while it heals.
After one or two days, all discomfort should be gone and you should be able to resume most normal activities. Recovery times may vary, so talk to your surgeon if you have any concerns. If you have cataracts in both eyes, you will most likely have the second surgery in a week or two.
Talk to you ophthalmologist about which surgical method would be best to remove your cataracts, and ask for more information on laser-assisted cataract surgery.
For more information, visit yoursightmatters.com/cataracts/cataract-surgery or www.seaislandophthalmology.com.