By the time Americans turn 80 years old, more than half the population has a cataract or has had cataract surgery, according to the National Eye Institute. It’s an extremely common and normal part of aging that affects the lens in the eye and ultimately leads to cloudy vision. But, there’s good news. Cataracts are very treatable with modern standard cataract surgery. The eye experts at UnityPoint Health - Finley Hospital are able to help treat your cataracts with modern standard cataract surgery as well as with the latest technology of laser assisted cataract surgery. Continue reading to learn more about Femtosecond Laser Assisted Cataract Surgery from surgery eye experts Juan Nieto, MD and Justin Risma, MD.
What is Femtosecond Laser Assisted Cataract Surgery and how is it different from traditional cataract surgery?
Standard cataract surgery uses microscopic sharp instruments to open the outer layer of the cataract, called the lens capsule, in order to access the cataract. Once the capsule is opened, the cataract is broken into smaller and smaller pieces manually with microscopic instruments. The small cataract pieces are then removed with an instrument that uses ultrasound energy to liquefy the cataract while simultaneously suctioning the cataract out of the eye. With femtosecond laser assisted cataract surgery, the precision of a laser is used to create the opening in the cataract capsule. This eliminates the need for one of the sharp instruments inside the eye. Additionally, the femtosecond laser can break the cataract into precise small fragments. This minimizes the amount of time spent manipulating the cataract inside the eye with microscopic instruments. Ultrasound energy is still used to liquefy and suction the cataract out of the eye, but the amount of ultrasound energy is typically reduced when the femtosecond laser is used.
What are the benefits of this surgery compared to traditional cataract surgery?
The femtosecond laser is used prior to the surgeon entering the eye with microscopic instruments. This essentially leads to the cataract being pre-treated. By opening the capsule and pre-treating the cataract with the femtosecond laser, the amount of time spent inside the eye during surgery is minimized. This has potential benefits in decreasing inflammation and swelling inside the eye on the first day after surgery. If the inflammation is decreased, the vision improvement from surgery may be appreciated sooner by the patient. Another benefit of the femtosecond laser is the incredible precision that it allows the surgeon to achieve when opening the capsule. The size of the opening is very important especially in presbyopia and astigmatism correcting intraocular lenses. If the capsule opening is too big or too small, cataract removal and centration of the intraocular lens may be more difficult. The femtosecond laser allows the surgeon to dictate the exact size of the opening, and the laser creates a perfect circular opening as programmed every time. For patients that have mild to moderate astigmatism prior to cataract surgery, the femtosecond laser can also be used to correct the astigmatism. With astigmatism correction, patients usually achieve better visual results due to less dependence on glasses after surgery.
Why is this a better option for patients?
Not all patients will benefit from the femtosecond laser, and the long-term data have not shown that femtosecond laser assisted cataract surgery is better than traditional cataract surgery. If patients elect to have astigmatism or presbyopia correction, the added precision of the femtosecond laser is definitely a strong reason to upgrade to femtosecond laser assisted surgery.
What is recovery like for patients?
The recovery after femtosecond laser assisted cataract surgery is the same as the recovery after traditional cataract surgery. The real benefits are in the added precision with the surgery itself. Additionally, if the inflammation and swelling in the eye is decreased on the first postoperative day, the vision may be clearer one or two days earlier compared to traditional cataract surgery.
Are there any risks associated with the procedure?
The risks of femtosecond laser assisted cataract surgery are the same risks that all cataract surgery patients take. There are always risks of infection, bleeding, retinal tear, retinal detachment, and swelling to name a few. However, we are fortunate that with modern technology and medicine, all of these risks are incredibly small for all patients.
Who is a good candidate for this procedure?
The ideal candidates for femtosecond laser assisted cataract surgery would be patients with mild to moderate astigmatism and patients who are interested in upgrading their intraocular lens choice to an astigmatism correcting or presbyopia correcting intraocular lens. However, the only way to see if you are a candidate for this technology is to have a thorough evaluation with an experienced cataract surgeon.