Cataract laser surgery involves the removal of part of the natural lens of the eye. The cataract itself is the result of metabolic changes, where the fibers in the lens deteriorate and result in impairment or serious loss of vision. Initially, patients may experience a strong glare from lights or have diminished visual ability in lower light levels. Correcting this problem with laser cataract surgery includes replacing the cloudy natural lens with a synthetic lens. This process restores the transparency of the lens and can greatly improve a patient’s vision.
The innovative technology responsible for this procedure, phacoemulsification cataract surgery, is a safe - and highly successful - form of medicine. In fact, the use of a laser adds another level of accuracy and improved results for the best long-term outcome. The laser establishes a specific, self-sealing incision, which creates an opening in the thin membrane around the natural lens of the eye.
This part of the surgery, labeled the capsulorhexis, is one of the most sensitive - and challenging - elements of the procedure. For example, during this stage, an Intra-Ocular Lens (IOL) goes into the membrane and is often the critical variable for a good refractive outcome.
This step further enables the surgeon to have enough room to remove the cataract. Upon removal, the capsular bag acts as a base to support the IOL. In the event that the capsulorhexis is not adequate, the IOL may tilt or move in the wrong direction. This reaction may interfere with the healing process or undermine the patient’s - and the physician’s - expected outcome.
The use of a femtosecond laser is typically the principal difference, compared to reliance on a traditional scalpel or manual capsulorhexis. In most instances, the femtosecond laser is accurate within 0.25 millimeters in diameter, while a significantly smaller percentage of patients get the same result with manual capsulorhexis. The consistency of the femtosecond laser - and the better lens positioning and visual outcomes from this procedure - underscores the value of this technique.
Another advantage of cataract laser surgery is the way this procedure easily readies the eye for the lens implant. By properly centering and positioning the IOL, laser cataract surgery achieves readily observable changes in patients of all backgrounds. The procedure even allows a doctor to see the multiple focal rings on the lens.
In contrast to conventional cataract surgery, which requires manual capsulorhexis and separation of the lens from the neighboring capsular bag, cataract laser surgery avoids the many complications that can ensue from this method. The manual technique still requires ultrasonic power - and the use of yet another instrument - to chop apart pieces of the lens. Complications may then ensue, including the rupturing of the capsular bag and trauma to the supporting zonular fibers, which hold the bag in place and maintain the natural shape of the lens.
Cataract laser surgery affords the IOL a better opportunity to properly function, while safeguarding the fibers in the lens. This procedure carefully removes or liquefies the cataract, giving the surgeon the flexibility necessary to complete the procedure. The surgeon can remove the liquefied cataract with greater speed and accuracy, which allows the patient a quicker road to recovery. The surgeon may also choose to vacuum out the liquefied cataract with an aspiration tool, which may not require any ultrasonic power.
Finally, there are several clinical studies and independent reports that show that cataract laser surgery requires less ultrasonic power than manual capsulorhexis. These reports further confirm that the laser may sufficiently liquefy the lens and not involve aspiration with any use of ultrasound. These benefits represent a clear preference for cataract laser surgery over manual capsulorhexis.