Cataract Surgery Options: Laser-Assisted vs. Traditional

Traditional cataract surgery, also known as manual or conventional cataract surgery, is the most commonly performed surgical approach worldwide. In this procedure, our cataract surgeons use a technique called phacoemulsification, which has proven effective over countless surgeries.

Here’s how traditional cataract surgery typically unfolds:

• Incision Creation: A small incision is made in the cornea with a scalpel. This incision is very precise and usually self-sealing, meaning stitches are generally not required.
• Capsulorhexis: The surgeon creates a small, circular opening in the capsule that surrounds the lens to gain access to the cataract.
• Lens Emulsification: A pen-shaped instrument emitting ultrasonic waves is inserted through the incision to break up the cloudy lens into tiny fragments. These fragments are then gently suctioned out of the eye.
• Lens Replacement: An artificial intraocular lens (IOL) is carefully placed into the eye, taking over the function of the natural lens to provide clear vision.

This method relies on the surgeon’s expertise and steady hands to ensure safety, accuracy, and a successful outcome. Most patients recover quickly, with vision gradually improving over a few weeks, even though full healing may take up to three months.

Laser-assisted cataract surgery, often referred to as femtosecond laser-assisted cataract surgery (FLACS), introduces state-of-the-art technology to assist with several key steps of the conventional procedure. This method has been in use for over a decade and can offer a number of advantages, especially in cases that require high precision.

In laser-assisted cataract surgery, a sophisticated camera coupled with an ultrasound device maps the eye’s surface, gathering detailed information about the lens and surrounding structures. Based on this information, a computer programs a femtosecond laser to perform several precise surgical tasks. Here’s a closer look at the process:

• Detailed Mapping: A specialized imaging device captures a 3-D map of your eye. By measuring the exact dimensions and location of the cataract, the laser can be programmed for precision incisions.
• Laser Incisions: Instead of using a manual scalpel, the laser creates the necessary corneal incision and forms the opening in the lens capsule. This precision often results in a nearly perfect, circular opening known as the capsulotomy.
• Cataract Softening: The laser is also used to pre-soften the cataract, reducing the amount of ultrasonic energy required later in the procedure. This step can help minimize trauma to the eye.
• Lens Removal and Replacement: After the laser steps are done, the remaining parts of the procedure mirror traditional surgery. The surgeon uses phacoemulsification to carefully remove the softened cataract fragments and then inserts the IOL.

Because of the enhanced imaging, a computer-guided incision, and the reduction in necessary ultrasound energy, laser-assisted cataract surgery can offer consistent and highly precise results. However, it is important to note that while some studies suggest a superior safety profile for specific cases, there is no clear consensus that this method provides drastically better outcomes for every patient.