What is a Laser?
A laser is a focused beam of light of a single wavelength. Each wavelength of light has different properties. They are generally divided between burning lasers and cold lasers. The wavelength of light for a particular procedure is chosen by what is needed to perform a particular operation.
Femtosecond Laser for Cataract Surgery
The femtosecond laser has been used in ophthalmology with making the corneal flap in Lasik since 2001. The femtosecond laser uses a mode-locking technique in optical in which the laser produces pulses of light in extreme short duration intervals in femtoseconds (10 ¯¹? s).
Laser Cataract Surgery
Many people think that when they hear laser cataract surgery that the laser removes the cataract. The laser does not remove the cataract but performs several steps in the process of removing a cataract. The laser is able to do portions of the cataract surgery that is currently being done manually by the eye surgeon.
Steps of the Cataract Surgery that Can Be Performed by the Laser
Clear Corneal Incision
The laser is able to precisely perform the corneal incisions used in cataract surgery that are usually performed by diamond or metal blade. The laser can make a stair-stepped or multi-plane self sealing incision.
The lens which becomes cloudy or hazy and then is a cataract is surrounded by a thin clear capsule. A capsulorhexis is a circular opening that is made on the anterior surface of the lens. The capsulorhexis is manually performed by the eye surgeon using a needle or forcep. This is a very delicate portion of the cataract surgery. The femtosecond laser is able to complete a capsulorhexis accurately to the precise size that the eye surgeon chooses which is typically 5mm in diameter. If this portion of the cataract is not completed correctly it can lead to several complications during the cataract surgery.
Phacofragmentation is the process of breaking up the nuclear portion of the lens during cataract surgery. Phacoemulsification for cataract surgery was developed by Dr. Charles Kelman in the late sixties. An ultrasound tip is inserted inside the eye to dissolve or emulsify the lens material. The femtosecond laser is able to assist in the fragmentation of the lens. The fragmentation of the lens by the laser reduces the ultrasound time by up to fifty percent. Ultrasound can damage the delicate cells inside the eye. The laser is able to reduce the ultrasound damage.
Limbal Relaxing Incisions for Correcting Astigmatism During Cataract Surgery
The femtosecond laser is able to make incisions on the cornea to correct astigmatism. This astigmatism is caused by the cornea being shaped more like a football versus a basketball. If a person is looking to be able to correct their astigmatism so that they will have good vision without glasses, they can have their astigmatism corrected by the laser. The laser is able to make these incisions is a more precise manner and gain a consistent result in correcting the astigmatism.
Cataract surgery by any method is covered by Medicare and insurances. With a regular cataract operation there cannot be any charge by the eye surgeon for using the laser. The procedure code for cataract surgery does not specify how the cataract is removed and includes any method. Medicare and insurance companies do not pay for presbyopic correcting intraocular lenses and correcting the astigmatism so that a person is able to see without glasses. Eye surgeons may charge for these services as they are not covered by Medicare or insurance companies. If you wish to have a laser perform a portion of the cataract surgery, the eye surgeon will charge above what Medicare or insurance pays for correcting the astigmatism portion of the surgery. You then receive the benefits of the laser assisted cataract surgery while having the astigmatism corrected.