Find Out if Laser-Guided Cataract Surgery Is Right for You
Laser surgery is gentler and more precise than conventional surgery, using computer-guided therapy to treat cataracts and astigmatism. Find out if you’re a candidate.
By: Richard Gans, MD
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Laser-guided surgery for cataracts may be a fairly new technology, but it’s quickly becoming the preferred way to treat cataracts and astigmatism.
Lasers have several advantages over conventional surgery, for the right patients.
For one thing, even though it’s effective, conventional surgery for cataracts is more invasive. In conventional surgery, we use hand-held blades to open the eye. Then, we use a probe that vibrates at ultrasonic speed to fragment the eye’s lens so that we can remove it and replace with an artificial plastic lens.
Using a laser, we accomplish many of these same tasks — but with computer guidance. It’s much more precise than the human hand alone.
It’s also much gentler on the eye than ultrasound. That’s especially important for certain patients with sensitive eyes.
For example, patients with Fuchs’ Corneal Dystrophy risk swollen corneas after surgery. Laser-guided surgery reduces the risk compared with conventional surgery.
Laser surgery has another advantage: the ability to correct some types of astigmatism.
Astigmatism is an irregularity of the eye’s curvature that can lead to vision distortion. With laser-guided surgery, we can correct astigmatism at the same time as the cataract surgery. This makes it less likely you will need glasses after the procedure.
But there are things you should be aware of before undergoing laser-guided surgery for cataracts. First, it’s a two-part operation. Even after the laser portion is completed, you must go into the operating room for the remainder of the procedure, where we physically remove the lens and replace it with an artificial lens.
Second, we never do this type of laser procedure for astigmatism alone. We only do it in conjunction with cataract surgery. There are ways to correct astigmatism without cataract surgery, but that’s a different laser procedure altogether, like LASIK (Laser-Assisted In Situ Keratomileusis).
Laser surgery for cataracts has some limitations. For example, the laser can’t correct all astigmatism.
Astigmatism can be either regular or irregular. If the cornea looks more like a football, the laser corrects it very well. If the astigmatism is irregular and has more of an egg shape, the laser doesn’t do nearly as good a job. There are some situations where we cannot correct the astigmatism at all, either with laser or conventional surgery. The patient just has to wear contacts or glasses.
Those who have had LASIK should probably avoid this procedure. LASIK creates a flap of tissue in the cornea, and when the laser fires it, it could change the characteristics of that flap and affect a person’s eyesight.
Patients are becoming much more demanding about achieving good vision after cataract surgery. In using a technology with such a high level of predictability, we expect to keep getting even better at giving people more precise, corrected vision.
Guide to laser vision correction