What is Laser Cataract Surgery?
Laser cataract surgery uses a complex imaging system and a femtosecond laser to both remove your cataract and reduce your astigmatism at the same time.
Cataract surgery is the most commonly performed surgery in the world and has saved the vision of millions. There has been steady progress in the quality of cataract surgery over the past forty years. Cataract surgery laser is the next logical step for improving accuracy and safety for the cataract removal procedure.
Laser cataract surgery raises the cataract procedure to new levels of safety and accuracy. The Eye Center of Northern Colorado was the twelth clinic in America to embrace this advance in eye care.
We have been helping our patients with laser cataract surgery since August, 2011. I peform both manual and cataract laser surgery, but have a strong and growing preference for the advantages offered by the cataract laser method.
Imaging the Eye
During basic cataract surgery, your eye surgeon looks through a microscope to judge your eye anatomy and uses steel blades and instruments to make incisions, open up the lens, and break it into smaller pieces for removal.
With laser cataract surgery, a high definition imaging system scans your eye and presents precise, magnified images of your eye on a screen for the surgeon to study. These images are presented in both a video image and a cross section image to your surgeon.
Your eye surgeon can use this additional information to design your cataract surgery laser on the screen. The laser cataract machine then delivers the planned treatment with superhuman accuracy.
What is Femtosecond Laser Cataract Surgery?
“Femtosecond” means a millionth of a billionth of a second. The laser used to do laser cataract surgery uses ultra short pulses at that amazingly fast speed which allows accuracy that no human hand could ever deliver.
The laser opens the capsule around your lens, divides your lens into small pieces, creates the incisions in your cornea, and decreases your astigmatism, all in less than a minute!
The light projected by the femtosecond laser is colorless so you can’t see it or even feel it while it corrects your vision.
What if I Move my Eye during Laser Cataract Surgery?
It is important that you hold your eye still for the minute time period of the cataract laser surgery. With the LensX laser system that I use most often for cataract surgery laser, a soft contact lens system connects to the eye with a gentle suction that holds the eye steady, making it easier to hold still during that short time. If needed, I can pause the cataract laser and then continue when you were ready.
Benefits of Laser Cataract Surgery
In basic cataract surgery, the eye surgeon tears an opening in the capsule that surrounds your lens by hand. This allows access to the cataract for removal. This maneuver is called the “capsulorhexis.”
The surgeon attempts to make this opening circular and the same size every time. With greater experience, a surgeon gets closer to this goal, but perfection is not achieved by even the best of surgeons and the opening looks more like a Charlie Brown smile. Deviations from the ideal can lead to less than accurate outcomes and visual distortion.
When the femtosecond cataract laser does the capsulorhexis, it is circular and the same size every time. Peer reviewed studies have show that the cataract laser delivers capsule openings that are more circular, more centered, and stronger.
One study showed them to be twice as strong and five times more accurate in size and shape. As a result, the final outcomes of the surgery have been shown to be more accurate with less intraocular lens tilt and less coma (an unwanted type of visual disturbance caused by a tilted intraocular lens).
In addition, because the laser cataract surgery machine softens the lens and divides it into small pieces, the cataract removal procedure is easier. Less energy, light, and fluid are run through the eye during the cataract removal making the procedure less traumatic for most patients. As a result, studies show that there is less swelling postoperatively in the cornea and retina than with basic cataract surgery.
It is important that you hold your eye still for the minute time period of the cataract laser surgery. With the LensX laser system that I use most often for cataract surgery laser, a soft contact lens system connects to the eye with a gentle suction that holds the eye steady, making it easier to hold still during that short time. If needed, I can pause the cataract laser and then continue when you were ready.
Complications of Laser Cataract Surgery
Laser cataract surgery has many distinct advantages over manual cataract surgery, but it is still surgery, so there can be complications. Infection, target error, inflammation, suction loss, and corneal edema are among the potential risks. If you want more information on the risks of laser cataract surgery, please click on the highlighted line to learn more.
Verion for Better Cataract Surgery Laser
The Eye Center of Northern Colorado will be the eighth center in the world to have the Verion sytem to improve the accuracy of laser cataract surgery and to reduce the chances for human error in the laser process. The Verion system measures your astigmatism, the center of your undilated pupil, and the center of your visual axis. It also takes a high definition photo of your eye at the same time.
This data is sent electronicly to the LensX laser cataract removal machine. This reduces human erros as the technitians do not have to re-enter all your data or the surgical plan.
The Verion system notices important landmarks on your eye and then notices those same landmarks on your eye as you look up at the laser during your laser cataract surgery. It uses those landmarks align your astimatism treatment to match the position of our eye. Amazing!
The Verion system also shows an overlay in the surgery planning screen during your laser cataract surgery that shows me the data from your preop. You are dilated for your surgery, but the overlay shows me where the center of your undilated pupil and visiual axis are located. This helps me better center the capsulorhexis on your eye. A better centration of the capulorhexis will improve accuragcy and even further decrease lens tilt.
Am I a candidate for Cataract Surgery Laser?
Cataract surgery laser is an ideal choice for many, but not all patients. Check with your optometrist to find out who offers this opportunity in your region and then meet with an eye surgeon that actually performs laser cataract surgery to find out if it is the best option for you and your future vision.
Surgeons that do not perform cataract surgery with a femtosecond laser will tend to recommend what they have available. If you see a an eye surgeon that performs both basic and laser cataract surgery you will be able to discuss all the options with an eye surgeon that can speak from experience about both options. I feel this is the ideal way to to have a balanced and informed discussion for your cataract removal procedure.
If I can answer any other questions for you about laser cataract surgery, please schedule a time to meet with me or post a question in the comments section below.
Gary J.L. Foster, MD
Board Certified Ophthalmologist
Cataract and Refractive Surgery
Fort Collins, Colorado 80525