Laser Cataract Surgery - East Valley Ophthalmology

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Laser Cataract SurgeryYou are here:

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5. Laser Cataract Surgery

Laser-Assisted Cataract Surgery

East Valley Ophthalmology offers the most advanced technology available, including the LensAR® femtosecond cataract surgery laser. This innovative approach to cataract surgery enables your surgeon to view the entire eye in greater detail for precise surgical planning, to soften the cataract more effectively in preparation for removal, to treat astigmatism with arcuate corneal incisions, and to ensure the accurate placement of your lens implant.

Why choose laser-assisted cataract surgery?

Laser cataract surgery is an advanced procedure that utilizes a unique imaging system to provide a sophisticated 3D view of your eye. This helps your surgeon plan and treat your cataract. With this technology, cataract removal becomes an exact procedure tailored to your eye’s unique size and shape.

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What are the benefits of laser-assisted cataract surgery?

Advanced laser-assisted cataract surgery yields the same outcome as traditional cataract surgery, but the difference lies in the tools used and the overall method employed. Blade-free laser-assisted cataract surgery both reduces the number of instruments used and increases the precision of the procedure.

Since no manual or blade instruments are used during the advanced cataract surgery procedure, some traditionally challenging steps of cataract surgery are now computer-controlled, automated, and serve as an overall safeguard in the procedure. The laser also allows for more precise capsulotomies and incisions from which the lens is removed.

Click on each section below to view its contents:

Will Medicare allow laser-assisted cataract surgery?

Under today’s Medicare guidelines, ONLY certain patients may be offered laser-assisted cataract surgery.

1. Astigmatism correction Your surgeon can offer laser-assisted cataract surgery if you are diagnosed with astigmatism during your eye exam and would like to have that refractive error corrected during cataract surgery. To correct astigmatism, a laser is used to create specific incisions in the cornea, reshaping it.
2. Premium lens implants Your surgeon can offer laser-assisted cataract surgery if you choose to have a premium lens implanted, such as an astigmatism-correcting toric IOL or a multifocal IOL. Your surgeon uses laser cataract removal technology to map the lens capsule more accurately and place the opening in the capsule with greater precision, allowing for better centering of the IOL.

Current Medicare guidelines state that a surgeon may not offer and charge for laser-assisted cataract surgery unless one of the two conditions above is met.

What benefits does laser cataract surgery offer?

With any cataract surgery, your outcome depends in large part on the skill and experience of your eye surgeon.  Using a laser for cataract surgery can enhance accuracy and consistency in the surgical steps, enabling your surgeon to make precise incisions.

Numerous studies have documented that laser-assisted cataract surgery can increase the precision and reproducibility of the anterior capsulotomy,1-3 reduce the adequate phacoemulsification time,1,4,5 cause less anterior chamber inflammation post-operatively,6, and potentially lessen surgically induced endothelial cell damage7 compared with conventional cataract surgery. All these factors associated with laser-assisted cataract surgery may further enhance the safety profile and visual outcomes of the traditional cataract procedure.

1. Nagy ZZ, Kránitz K, Takacs AI, et al. Comparison of intraocular lens decentration parameters after femtosecond laser in cataract surgery. J Refract Surg. 2011 Aug:27(8):564-9.

2. Friedman NJ, Palanker DV, Schuele G, et al. Femtosecond laser capsulotomy. J Cataract Refract Surg. 2011 Jul;37(7):1189-98.

3. Kránitz K, Takacs A, Miháltz K, et al. Femtosecond laser capsulotomy and manual continuous curvilinear capsulorhexis parameters and their effects on intraocular lens centration. J Refract Surg. 2011 Aug;27(8):558-63.

4. Abell RG, Kerr NM, Vote BJ. Femtosecond laser-assisted cataract surgery compared with conventional cataract surgery. Clin Experiment  Ophthalmol. 2013 Jul:41(5):455-62.

5. Abell RG, Kerr NM, Vote BJ. Toward zero effective phacoemulsification time using femtosecond laser pretreatment. Ophthalmology. 2013 May:120(5):942-8.

6. Abell RG, Allen PL, Vote BJ. Anterior chamber flare after femtosecond laser-assisted cataract surgery. J Cataract Refract Surg. 2013 Sep;39(9):1321-6.

7. Conrad-Hengerer I, Juburi MA, Schultz T, et al. Corneal endothelial cell loss and corneal thickness in conventional compared with femtosecond laser-assisted cataract surgery: Three-month follow-up. J Cataract Refract Surg. 2013 Sep;39(9):1307-13.

How is traditional cataract surgery done?

With traditional cataract surgery

1. The eye surgeon creates a small incision in the side of the cornea by hand with a tiny blade known as a keratome.
2. An instrument is inserted through this incision into the area behind the pupil where the eye’s lens is located.
3. The surgeon uses a tiny surgical instrument to create a circular opening in the lens capsule.
4. A special pen-shaped probe is inserted through that opening to apply ultrasound waves (phacoemulsification) to break up the cloudy center of the lens, allowing it to be removed using the phacoemulsification handpiece.
5. Using the same small incision, the surgeon implants an artificial intraocular lens to replace the cloudy natural lens.
6. The corneal incision typically self-seals after surgery, so stitches are not commonly needed.

How is laser-assisted cataract surgery done?

Laser-assisted cataract surgery has been used to remove cataracts for the past decade. With laser cataract surgery, the doctors at East Valley Ophthalmology will customize the procedure to your eye’s unique characteristics. The use of a laser can improve the precision and accuracy of each of these steps, potentially reducing risks and enhancing the visual outcomes of cataract surgery.  An advanced femtosecond laser assists with the following steps in cataract surgery:

1. An imaging device is placed over your eye to gather information about the lens. Special software will create a surgical plan with a 3D image of the eye, utilizing either optical coherence tomography (OCT) or Scheimpflug imaging. The plan includes the location, depth, and length of the cataract in all planes.
2. The imaging device sends detailed information to a computer that programs the laser for the exact location, size, and depth of the incisions.
3. The surgeon uses the laser to make the corneal incision and the opening in the lens capsule. Energy from the laser may also be used to soften the cataract. Light energy from the laser causes disruption of tissue borders with minimal damage to nearby tissue.
4. An ultrasound probe is used to break the lens into pieces and suction them out of the eye.
5. The new lens is inserted. The corneal incision usually does not require stitches.

Which cataract surgery has a shorter recovery time?

Both manual and femtosecond laser cataract surgery are done on an outpatient basis.  The recovery period for both laser-assisted cataract surgery and traditional cataract surgery is the same. Most patients can resume their normal activities fairly rapidly, within one to two days.  Complete visual recovery varies from patient to patient, but typically, patients experience improvement in their vision almost immediately.

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