What is Laser Cataract Surgery?
Portions of cataract surgery can now be performed with a laser. The laser is able to complete several different steps in a cataract operation. The laser is able to make the incisions in the eye used for instruments that are inserted into the eye during cataract surgery. The laser also makes the capsulorrhexis in a very precise manner compared to the eye surgeon making this manually. The laser also makes cuts in the nuclear portion of the lens in a variety of fashions that can be chosen by the surgeon. The remainder of the cataract surgery is performed in the normal manner as with other cataract surgeries.
Is Laser Assisted Cataract Surgery Better than Regular Cataract Surgery?
There are numerous studies that are being done to study laser cataract surgery. Several studies have already been completed comparing the results between regular cataract surgery and laser cataract surgery. Many surgeons also have an opinion based on their experience with laser assisted cataract surgery. The final answer is still not completely known at this time.
A small secondary incision is usually used during cataract surgery. There is no real difference between on a laser performs this incision versus manually making the incision.
The primary incision is the primary incision used during cataract surgery. The width and design of the incision can vary from an incision size of 1.8mm to 3.0mm in width. The laser can make this but also perform it in a three step plane. The three step plane incision provides a water tight incision that is more stable and leak proof.
Limbal Relaxing Incision
Limbal relaxing incisions are used to correct astigmatism during or after cataract surgery. People who wish to have good vision without glasses need to have their astigmatism corrected in order to have clear vision without glasses. In simple terms astigmatism is due to the cornea being shaped like a football versus a basketball. This causes the light that enters the eye to be focused into a line versus a clear point. Glasses or contacts are normally used to correct the astigmatism.
The lens inside the eye that becomes cloudy (cataract) is surrounded by a thin capsule that has the characteristic of cellophane wrap. A central opening is made manually by the surgeon or precisely made by the femtosecond laser. The laser can make this opening exactly as programmed by the eye surgeon. The manually made capsulorrhexis may vary in size, shape and centration.
The femtosecond laser is able fragment the lens in patterns designed by the eye surgeon. The lens can be sectioned with or without central rings of fragmentation. This allows the surgeon to remove the cloudy lens material with less ultrasound time. This can reduce the complication rate during cataract surgery.
The femtosecond laser used during cataract surgery can perform a variety of different portions of the cataract surgery. The laser is able to accurately perform limbal relaxing incisions precisely compared to manual incisions. The astigmatism can be more accurately treated with using the femtosecond laser. The capsulorrhexis can also be made precisely as to size, centration, and shape with the laser. The ultrasound time used to remove the cataract is reduced during cataract surgery with the femtosecond laser. This can also reduce complications related to cataract surgery. The amount of improvement with cataract surgery while using the femtosecond laser needs to be further studied but it appears to improve the safety and quality of cataract surgery.