Friday, April 19, 2024

Laser Eye Surgery For Cataracts

What Other Eye Surgeons Say About Laser

Is Laser Cataract Surgery better than tradional Microincision Cataract Surgery? – Dr. Samina

There has been a sea-change in attitudes about laser-assisted cataract surgery in the last few years. A decade ago, many leading eye surgeons believed that this was the future of cataract surgery. Now, many of them have changed their minds.

Richard Lindstrom, MD is a recognized authority in the world of eye surgery. Hes part of a high-volume cataract practice in Minnesota, and a presenter I make sure to catch any time hes at a conference Im attending. Hes also served as a consultant on the advisory board for two companies that make the lasers used in laser-assisted cataract surgery, and even owned equity in those companies. He purchased one of the first 10 FLACS lasers sold in the United States, and integrated it fully into the cataract surgery program in his practice.

In Dr. Lindstroms own words, one could argue that few individuals in the world want FLACS to be a greater success than me.

Nevertheless, Dr. Lindstrom writes that he has now reduced my personal FLACS usage to zero.

Like the studies we looked at earlier, in Dr. Lindstroms personal experience , laser-assisted cataract surgery simply doesnt outperform manual cataract surgery in the long term.

While Dr. Lindstrom sees promise in potential future developments in new technologies for laser-assisted cataract surgery, for now, its not for him and many other early-adopters of the technology.

Femtosecond Or Laser Cataract Surgery

Catalys femtosecond cataract surgery is one of the most advanced methods for removing cataracts. This laser-guided computerized technique helps surgeons improve vision and decrease complications after surgery.

The Catalys system is safer for patients. The femtosecond laser uses much less energy to break up the cloudy lens than the older ultrasound techniques. This decreases the risk of swelling in the retina after surgery. Since the laser isnt directed at the cornea, or clear tissue in front of the iris, it cant cause a loss of cells that can create swelling and vision irregularities. In addition, the laser is computer-guided, so the bag, or capsule, holding the cataract is more stable with less risk of rupture. An intact capsule can hold the implant lens in place much more securely, which in turn optimizes vision.

The Liquid Optics interface is gentle on the eye. It creates a wide view for the surgeon so that he or she can see the entire front section of the eye without having to remove the lens. This improves comfort. The portion that touches the eye is called a dock. The Catalys system uses a soft dock, while other femtosecond lasers use a rigid one. As a result, this system applies almost no pressure on the eye surface. Increased intraocular pressure with the use of rigid docks would increase the risk of glaucoma complications.

Whats It Like Recovering After Laser Cataract Surgery

As long as you follow your eye doctors instructions, you will likely be able to return to your normal activities within a day or two. Although you may experience some very mild soreness or discomfort initially, it should not be a painful experience overall.

You will be instructed to go home and relax for the rest of the day after your procedure. The best thing you can do is rest as soon as you can and as much as you need to, as sleep is essential to recovery.

Do not plan on driving for the rest of the day after you have laser cataract surgery. It is unsafe to operate a vehicle, as your vision will be affected, and you may be drowsy. A driver is also needed for your appointment the following day.

You will need to avoid heavy lifting for a week after your procedure. You will also need to avoid eye makeup and swimming for two weeks Water can introduce infectious bacteria and germs, and your eye will be more prone to infection while recovering.

After a week or two, you should be back to your regular routine. You will still need to be vigilant to protect your eyes. Wear protective eyewear when needed and wear sunglasses while outside. Do not rub your eyes at any point during the recovery. If your eyes are uncomfortable, you can use the eye drops recommended by your doctor.

Full recovery can take a few weeks, but it depends on the patient. The length and difficulty of your recovery depend on your bodys natural ability to heal.

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What To Expect On The Day Of Surgery

Cataract surgery itself takes about 20 minutes. But between signing in, getting prepared for your surgery, and postoperative recovery, you can expect to spend between one to three hours at your appointment.

When you arrive at your appointment, you will register and sign a consent form. You will go to a pre-operative area where you will have your temperature, pulse, blood pressure, respiratory rate, and oxygen saturation checked.

You will have an IV line placed in your arm or hand. Your ophthalmologist and your anesthesiologist might see you before your surgery.

Learn What To Expect After Cataract Surgery

Laser Surgery for Cataracts: Prep, Recovery, Long

Patients are often excited about the results of their laser cataract surgery. This procedure can help you see more clearly during everyday activities, including driving. If you want to know what to expect after cataract surgery, meet with our trusted physicians Dr. Ming Wang and Dr. Josh Frenkel. At Wang Vision Institute in Nashville, TN, our goal is to help you achieve a lifetime of improved vision.

When To Drive Safely Again

It is important that you do not operate any vehicles until Dr. Wang or Dr. Frenkel gives you clearance first. It could be that we recommend waiting a little longer before driving again due to safety concerns. The amount of time you need to wait depends on factors such as your eye health and whether you experienced any complications during laser cataract surgery. That said, we estimate waiting several days to several weeks before getting behind the wheel again.

Post Cataract Surgery Yag Laser Capsulotomy

One of the most common problems after cataract surgery is clouding of the membrane around the lens. This membrane is referred to as the posterior capsule, and once the membrane becomes cloudy, the condition is termed posterior capsule opacification. A cloudy posterior capsule causes blurry vision, but this condition is easily and safely remedied with laser treatment at our Jefferson City office.

During cataract surgery, the surgeon removed the cloudy, natural lens of your eye and replaced it with an intraocular lens . Much of the thin clear membrane that surrounds the natural lens was left intact during surgery, and the IOL was implanted within it. When the cataract was removed, your surgeon made every attempt to maintain the integrity of the lens capsule so that the IOL is held safely in place.

In about 40-50% of patients, the posterior portion of the capsule becomes hazy after cataract surgery, causing posterior capsule opacification. This occurs because cells within the eye grow on the capsule. In extreme cases, your vision could be worse than it was before cataract surgery if the condition progresses significantly.

Does Laser Eye Surgery Interfere With Me Having Cataract Surgery When I Am Older

No, laser surgery does not interfere in any way with having cataract surgery later on, if you need it.

The normal lens in the eye is removed during cataract surgery and replaced with an artificial lens called an IOL. A device, called an optical biometer, measures the eye. This calculates the correct power of IOL. Part of this calculation involves measuring the curvature of the cornea which is reshaped with laser eye surgery such as LASIK or SMILE. Previously, the reshaped cornea interfered with the calculations made by the biometer, often resulting in refractive surprises. The interference introduced inaccuracies and errors in the choice of IOL. However in recent years, we have a better understanding of why this occurs and we also have better biometers which can compensate for corneas which have been reshaped by LASIK or SMILE. Now choosing a suitable IOL for someone who has had laser eye surgery is just as accurate as it is for someone who has never had laser eye surgery.

Astigmatism Correction At The Time Of Cataract Surgery

Laser Precision Restores Vision after Cataracts

To reduce the need for prescription eyeglasses or reading glasses after cataract surgery, it is important that little or no astigmatism is present after implantation of presbyopia-correcting multifocal IOLs and accommodating IOLs.

Astigmatism usually is caused by the cornea being more curved in one meridian than others. .

To reduce astigmatism, small incisions can be placed in the periphery of the more curved meridian as the incisions heal, this meridian flattens slightly to give the cornea a rounder, more symmetrical shape.

This procedure is called limbal relaxing incisions or astigmatic keratotomy . Surgeons can perform LRI or AK manually with a diamond blade, and it is quite effective in reducing astigmatism.

During refractive laser-assisted cataract surgery, the OCT image can be used to plan laser LRI or AK incisions in a very precise location, length and depth. This increases the accuracy of the astigmatism-reducing procedure and the probability of good vision without glasses after cataract surgery.

Is Investing In Laser Cataract Surgery Worth It

Im a strong advocate of investing in your vision, when it makes sense. Im also a strong advocate of making informed investments.

When it comes to laser-assisted cataract surgery, finding clear answers about the value of that investment can be difficult.

First, let me admit that I admire and like the lasers we use for laser-assisted cataract surgeries. Theyre impressive pieces of equipment. Each unit costs between $300,000 $500,000, and theyre made up of precision optics and electronics that enable them to perform parts of the incredibly delicate work of cataract surgery. I havent met an ophthalmologist who isnt at least a bit of an equipment geek, and Id be lying if I said I didnt appreciate the technology of FLACS.

But does that technology lead to better outcomes?

When the manufacturers of those $300-$500K FLACS lasers tout their benefits, they tend to focus on things like precision and repeatability that machine-driven lasers are really good at. Robots are really good at performing repetitive tasks, the exact same way, every time.

But does that precision and repeatability lead to better outcomes?

If you take a step back, look at a broader cross-section of data and larger independent studies, the clinical benefits of femtosecond laser-assisted cataract surgery arent quite so clear.

Lets take a look at exactly what laser-assisted cataract surgery is, and then well take a closer look at some of those outcomes.

Removal Of The Cataract

Another step in the UltraView ReLACS procedure involves the laser being applied to the substance of the cataract to soften it. This allows the cataract to be removed with more ease, reducing the amount of ultrasound energy applied inside the eye. As a result, there is less chance of breaking the capsule, corneal wound burn from heat generated by the ultrasound, and swelling of the cornea from internal damage caused by ultrasound.

Better Vision Following Cataract Surgery

The laser is particularly useful when a cataract is dense or the opening is difficult to create. However, the lasers accuracy is also important when surgeons want to implant a multifocal lens, which corrects distance and close-up vision, or a toric lens that corrects astigmatism, Dr. Horne said. We use these lenses when patients want more options in terms of how they function with their vision, such as wanting to drive, read, do computer work, or play golf without needing to wear glasses. The precision of the laser, its ability to consistently create incisions helps us do that.

A laser can also be used to correct minor astigmatism by reshaping an imperfectly curved cornea. Often, we can do that by hand, but the laser allows us to do it more reliably and more precisely, she said. This leads to a better and more predictable vision outcome.

Because the laser requires less energy than ultrasound to break up the cataract, it also reduces the risk of corneal swelling, which can impact vision. If we use less energy and have less corneal swelling, the eye can heal faster, Dr. Horne said.

How Does It Work

Cataract Surgery

Your cataract surgeon offers the laser as part of your advanced cataract procedure because it is safe, effective and uses the same proven laser technology thats been used in LASIK procedures for over a decade. Other benefits include:

  • A unique, high-resolution 3-D model of your eye that allows your cataract surgeon to tailor your treatment, which can improve visual outcomes.
  • Use of the most advanced technology available, which may reduce the time it takes to remove your cataracts.
  • Designed with comfort in mind, so you can relax, knowing you have the latest laser technology available to treat one of your most valuable senses your sight.
  • HOW DOES THE LASER ADVANCE A TRADITIONAL CATARACT SURGERY?

    The laser technology allows your cataract surgeon to offer you a better, more precise cataract removal procedure that is customized to your eye. The lasers unique imaging system provides your cataract surgeon with a reconstructed 3-D view of your eye, to help plan and treat your cataract, which ensures that your customized cataract procedure is performed with laser precision.

    Is Laser Cataract Surgery Safer Than Traditional

    For millions of Americans, cataracts are a normal part of the aging process. While theyre common, treating cataracts often requires surgery. Traditionally, cataract surgery has been performed with small, handheld instruments, like scalpels and probes. But medical advancements now allow for most cataract surgeries to be performed with the assistance of lasers. Laser cataract surgery has many benefits, and the team at Kirk Eye Center can help Chicago area residents determine the best course of treatment for their cataracts. Visit our River Forest or Gurnee, IL locations for an exam by our team of vision care professionals.

    How Is Traditional Cataract Surgery Done

    With traditional cataract surgery

  • The eye surgeon creates a small incision in the side of the cornea by hand with a tiny blade known as a keratome.
  • An instrument is inserted through this incision into the area behind the pupil where the eyes lens is located.
  • The surgeon uses a tiny surgical instrument to create a circular opening in the lens capsule.
  • A special pen-shaped probe is inserted through that opening to apply ultrasound waves to break up the cloudy center of the lens so it can be removed using the phacoemulsification hand piece.
  • Using the same small incision, the surgeon implants an artificial intraocular lens to replace the cloudy natural lens.
  • The corneal incision will typically self-seal after surgery, so most commonly stitches are not needed.
  • Cost Of Laser Cataract Surgery

    Laser cataract surgery usually costs more than conventional cataract surgery, and the extra costs associated with laser cataract surgery typically are not covered by medical or health insurance.

    Fees for laser cataract surgery can vary significantly from one cataract surgeon to another. Be sure to ask about details of the cost of laser-assisted cataract surgery during your pre-surgical exam and cataract surgery consultation with your surgeon.

    Does Ohip Cover Cataract Surgery

    Laser-Assisted Cataract Surgery @ Eye Medical Center of Fresno

    OHIP covers surgeon fees, the cost of testing using an ultrasound, and the standard lens implant for cataract eye surgery. There are specialized diagnostics, additional procedures, special feature implants, and specific lasers listed under the non-insured services. Our staff can help you understand the details so you can make an informed decision accordingly.

    Which Type Of Cataract Surgery Has A Shorter Recovery Time

    The recovery time for all three types of cataract surgery is the same. Some people can see clearly almost immediately. Others may find their vision slightly blurred in the first few days following surgery however, this then clears within a week or two. It takes about three months for vision to fully recover from and stabilise following cataract surgery.

    Preparing For Cataract Laser Eye Surgery

    Your doctor may ask you to do the following to help you get ready for the procedure:

    • Take TestsYour doctor will perform an ultrasound exam that is painless to measure the shape and size of your eye. This will help them to get the most suitable artificial lens for you.
    • Stop the Intake of Specific MedicationsThey will ask about the medicines you are taking and may advise you to stop using those that could raise the chances of bleeding and interfere with the surgery.
    • Use Eye DropsYour eye doctor may prescribe antibiotic eye drops and advise you to it use 2-3 days before the procedure.
    • Fast Before the Surgery

    Do People Ever Have Laser Eye Surgery After Having Cataract Surgery

    Laser eye surgery is sometimes carried out on people who have had cataract surgery. The reason for doing this is usually that the vision has not been fully corrected by the cataract surgery. This can mean that the persons eye is short or longsighted or has astigmatism, resulting in less than optimal vision. This problem can often be corrected by exchanging the original IOL for a different lens which fully corrects the vision in the affected eye. In some cases, however, it is not possible or appropriate to carry out an IOL exchange. In this situation, laser eye surgery can be highly effective at correcting the vision. The results are generally just as good as what is achieved in those whove not had cataract surgery.

    To find out more about laser eye surgery at the Wellington Eye Centre and whether youre suitable, get in touch. Or book in for a free, no obligation, initial laser suitability assessment.

    What If My Vision Gets Cloudy After Surgery

    Laser Cataract Surgery and Phacoemulsification Cataract Surgery

    Sometimes after cataract surgery, you may find that things start to look cloudy again. It happens because a lens capsule — the part of your eye that holds your new artificial lens in place — begins to thicken up.

    You may hear your doctor call this by its medical name: posterior capsule opacification. The problem may not show up right away. You may notice it months or years later.

    Your doctor may suggest a procedure called a YAG laser to fix it. This surgery takes a few minutes and is painless. A surgeon uses a laser to open up the thickening around the lens capsule and let more light get through your artificial lens. That will clear up your cloudy vision.

    Show Sources

    American Academy of Ophthalmology: “When Is the Right Time to Have Cataract Surgery?” “Cataract Surgery,” “What Is Macular Degeneration?” “How Soon Can YAG Be Done After Cataract Surgery?”

    Mayo Clinic: “Cataract Surgery: What You Can Expect.”

    Digital Journal of Ophthalmology: “The Risks and Benefits of Cataract Surgery.”

    American Foundation for the Blind/VisionAware: “Our Readers Want To Know: When Should I Have Cataract Surgery?” “What are the Risks of Cataract Surgery?”

    National Eye Institute: “Facts About Cataract.”

    American Optometric Association: “Cataract Surgery.”

    Vision Australia: “Cataracts.”

    British Medical Journal: “Cataracts: Should I Have Surgery?”

    Royal National Institute of Blind People: “Posterior capsule opacification — why laser treatment is sometimes needed following cataract surgery.”

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