Laser Assisted Cataract Surgery
Laser-Assisted Cataract Surgery (LACS), also known generally as Laser Cataract Surgery.
A New Era in Cataract Surgery
Traditional cataract surgery is one of the most frequently performed surgeries and also one of the most safe and effective, with predictable outcomes. It is highly dependent on surgeon skill, volume and experience. With Laser-Assisted Cataract Surgery your surgeon will operate using the Laser, which offers a level of accuracy exceeding that of manual surgery.
The Cataract Incision
When it is made with a human hand guiding a blade, there are limitations. A bladeless, computer-controlled laser helps surgeons perform your surgery with exacting, individualized precision not attainable with traditional surgical methods.
In traditional cataract surgery, the eye surgeon uses a hand-held metal or diamond blade to create an incision in the area where the sclera (white part of the eye) meets the cornea. The goal in creating this incision is to go a partial depth vertically, then horizontally in the cornea and then enter into the eye. The reason cataract incisions are created in a two- or three-plane fashion is so they will self-seal when surgery is complete, allowing for a no-stitch approach.
With the laser-assisted approach to cataract surgery, the surgeon creates a precise surgical plan with a sophisticated imaging of the eye. The goal is to create a perfect incision with a specific location, depth and length in all planes so that it interlocks precisely and improves the chance of self sealing. With the special imaging and a femtosecond laser, it can be performed exactly, making a perfect incision that interlocks precisely and improves the chance of self-sealing. This is an advancement over traditional manual technology.
The eye's natural lens is surrounded by a capsule that is very thin and very clear. In cataract surgery the front portion of the capsule is removed in a step called the capsulotomy, to gain access to the cataract. It is important that this capsule not be damaged during cataract surgery, because it must hold the artificial lens implant in place for the rest of the patient's life.
In traditional cataract surgery, the surgeon creates an opening in the capsule with a small needle and then uses that same needle or a forceps to tear the capsule in a circular fashion. The opening should be a continuous tear that is 5 to 6 mm in diameter and well-centered so it can be a precise fit for the artificial lens to be implanted.
With the laser-assisted approach studies have already shown that this very important capsulotomy step works better with the laser in terms of accuracy and reproducibility. Studies have also shown that laser capsulotomies enable better centering of the intraocular lens (IOL), and IOL positioning is a significant factor in determining final visual outcomes.
Removal of the Cataract
After the capsulotomy, the surgeon now has access to the cataract, the cloudy natural lens to remove it.
In traditional cataract surgery, the ultrasonic device that breaks up the cataract is inserted into the incision. This is known as phacoemulsification. During this procedure, ultrasound energy is dissipated in the eye. Some cataracts may require longer phacoemulsification time. This excessive energy can lead to complications and negatively affect the visual outcome. This is important to consider.
With the laser-assisted approach the laser, on the other hand, softens the cataract as it breaks it up. By breaking up the cataract into smaller, softer pieces, less energy should be needed to remove the cataract, so there should be less chance of complications.
Using the laser should also result in less chance of capsule breakage. This is the back portion of the capsule that houses the natural lens. After the calculation of the proper implant power, there is no step more important for visual outcome than preservation of the capsule that the natural lens is surrounded by. This capsule is as thin as cellophane wrap and is important to leave undamaged so that it can hold the artificial lens implant in the proper position.
The reduced energy of the laser may also make the procedure safer to the inner eye, which reduces the chance of certain complications, such as a detached retina.
Intraocular Lens Implant
In the final step of cataract surgery an intraocular lens (IOL) is inserted and implanted. This is a clear artificial lens to replace the cloudy natural lens. There are various lens options available that can help improve your vision to reduce the need for glasses.
Cost of Laser Cataract Surgery
Extra costs associated with laser cataract surgery are unlikely to be covered by Medicare or private health insurance. Fees vary from one cataract surgeon to another, schedule a consultation with our refractive coordinator to learn about pricing and finance options.
Cataract surgeons who use lasers say that their advantages are especially evident when it comes to high-tech, premium implants such as presbyopia-correcting multifocal IOLs and accommodating IOLs. The advantages can include better lens placement and therefore more accurate visual outcomes.