Advantages of Laser Cataract Surgery
Most people will need cataract surgery at some stage of their lives, particularly after the age of 60. Current techniques offer an opportunity to address not only your cataract but also your dependence on glasses. At the pinnacle of modern advances in medicine is CATALYS laser cataract surgery. This has been shown to be a safer, faster and more accurate technique, leading to better outcomes and fewer complications – even in complex cases.
What is cataract microsurgery?
The symptoms of cataract include blurred vision (even with glasses), poor night vision, glare and washed-out colours. These result from a clouding of the natural lens in your eye (your crystalline lens). This is most often a natural ageing process, but is accelerated by exposure to UV light from the sun, certain medicines and illnesses such as diabetes, or trauma.
Treatment is cataract microsurgery – one of the safest and most successful procedures in modern medicine. The contents of your cloudy lens are removed from the eye and replaced with an artificial lens called an intra-ocular lens (IOL). This IOL can be selected to match your natural lens, or to correct your eyesight if you are short-sighted or long-sighted. It can even correct your astigmatism.
Laser cataract surgery vs traditional
Laser cataract surgery differs from traditional methods by replacing three of the manual steps of the procedure with a laser instead of mechanical blades and tools:
1. Creating an entry point
This occurs on the surface of your eye at the junction of your cornea (the clear window) and the white of your eye. Traditionally it is created with a metal blade. Laser cataract surgery uses a femtosecond laser to create this entry. One advantage is that the laser (unlike a blade) can create a channel that fits together like a jigsaw puzzle once the surgical instruments are removed at the end of the procedure. This can assist with healing and reduce corneal swelling. A blade never touches your eye.
2. Through the round window: accessing the cloudy part of your lens
Your crystalline lens is a little like an avocado, in that it has a peel (called a capsule), the fruit (called the cortex) and the pip (called the nucleus). The capsule remains clear even when the cortex and nucleus become cloudy with age and exposure to UV light (i.e. when you have a cataract).
Traditional cataract surgery requires the surgeon to pinch a tiny piece of the capsule (peel) with a surgical instrument and to gently, but deftly, tear it away in a circle. This takes years of practice to get it right and it doesn’t always go according to plan. Complications with creating this entry are associated with poorer outcomes. Laser cataract surgery is different. It uses a laser to make a perfectly round and centred porthole to your underlying lens.
3. Removing the cloudy lens
The third step of this surgical procedure that is replaced with a laser rather than mechanical tools, is the preparation of the nucleus – the cloudy part of your lens – for removal. It’s also useful to think of the lens capsule as the outer layer of a peanut M and M. The cortex is like the chocolate layer and the nucleus is the peanut. Removing the cataract is like removing the chocolate and peanut while keeping the candy layer intact. Traditional methods carve up the peanut with a surgical probe before it is suctioned out of the eye. But the latest laser techniques use a laser instead of an instrument to divide the ‘peanut’ into a grid of small, separate squares that can easily be vacuumed from the eye.
Why is laser cataract surgery better?
Using a laser instead of metal tools for these three important steps of your procedure has a number of advantages:
1. Quicker: these steps are typically faster with a laser compared to manual techniques. And quicker surgery means less time under anaesthetic and with your eye exposed.
2. More gentle: your natural lens is held in place by a ring of elastic threads or fibres. This web of fibres suspends your lens within the eye. They are anchored to a part of your eye just behind your iris – the coloured part. In certain cases, traction on the lens during surgery can sometimes rupture these fibres and cause your lens to move out of position. Laser techniques require less physical manipulation of your eye, and have been shown to reduce the risk of this kind of complication.
3. Less energy used inside your eye: the longer the procedure takes, the more energy your eye is exposed to. This has implications for swelling in your cornea as well as vibrations within the delicate structures of your eye.
4. More accurate: creating a perfectly round, perfectly central access to your lens can lead to more accurate placement of the IOL, which in turn leads to crisper, clearer vision. It can also mean less dependence on glasses after surgery – or complete independence from corrective eyewear.
What do the studies show?
In their paper ‘Femtosecond laser cataract surgery’ Nagy and McAlinder examine how this surgical advance improves ‘consistency and predictability for corneal incisions and anterior capsulorhexis’. In other words, step 1 and 2 above are more consistent and predictable using a laser rather than a mechanical tool. They go on to say that the laser technique is quicker and uses less energy. This reduces swelling at the surface of your eye. They also mention further advantages of a more circular and centrally-placed access to your lens. This allows the IOL to be more accurately positioned. And THIS in turn leads to better vision and less dependence on glasses after surgery. You can view the difference between the laser and traditional technique and download the whole paper here.
Still have some questions about laser cataract surgery? Learn more about the CATALYS laser cataract advantage HERE. Or Book your FREE appointment with Dr David Robinson at Sydney Laser and Vision Centre today and take the next step to leading your best life!
