Is Laser-Assisted Cataract Surgery Better Than Traditional Cataract Surgery ?

June 14, 2023

Femtosecond Laser-assisted cataract surgery is an advanced technique that utilizes Laser technology to assist in specific steps of the cataract removal process. While both Laser-assisted and traditional cataract surgery is effective in restoring vision impaired by cataracts, the Laser-assisted approach offers certain advantages over traditional surgery, including but not limited to the following:

  1. Precision
  2. Customization
  3. Potential for improved visual outcomes
  4. Recovery period

Here we will outline both procedures and explain which option is better for you. Let’s dive in.

How Does A Traditional Cataract Surgery Perform?

Traditional cataract surgery, or Phacoemulsification, is a standard and effective surgical procedure to remove cataracts.

Here’s a step-by-step overview of the traditional cataract surgery:

  • Anesthesia: Before the surgery begins, the anesthesiologist injects local anesthesia into the patient’s affected eye to numb the eye. 
  • Incision: Then eye surgeon makes around 2-3 millimeters incision on the side of the cornea. 
  • Capsulotomy: The surgeon creates an opening in the front of the thin capsule surrounding the lens. This opening allows access to the cataract.
  • Phacoemulsification: Eye surgeons insert a tiny probe through the incision. This probe emits ultrasound waves that break up the cataract into small pieces. Next, they suction out these fragments through this probe.
  • Lens implantation: After cataract removal, surgeons implant an artificial lens called the Intraocular lens (IOL).
  • Closure: The incision is usually self-sealing and does not require sutures. In some instances, surgeons use medical adhesive to initiate fast healing.
  • Recovery: After the surgery, the patient is monitored and provided with an eye shield or protective glasses. Most patients can go home on the same day. The eye will gradually heal over time.

How Does A Laser Cataract Surgery Perform?

Laser cataract surgery, or femtosecond laser-assisted cataract surgery, is an advanced technique that uses a laser to assist in various steps of the cataract removal process. 

Here’s a step-by-step overview of femtosecond laser-assisted cataract surgery:

  • Anesthesia: Same as the traditional cataract removal procedure.
  • Incision and Capsulotomy: Here, surgeons don’t create incisions manually; they perform Capsulotomy with a blade or a needle. They use the Femtosecond Laser to perform these steps. The Laser makes precise incisions in the cornea and a circular opening in the lens capsule, allowing access to the cataract.
  • Lens Fragmentation: The Laser softens and fragments the cataract. It emits short energy pulses to break the cloudy lens into smaller, more manageable pieces.
  • Phacoemulsification: After the pre-fragmentation of the cataract, the surgeon proceeds with Phacoemulsification. They insert a small probe through the incision and use ultra-sonic vibration to break the fragments further. Then they finally suction out the remaining cataract fragments.
  • Lens Implantation: As in traditional cataract surgery, an artificial Intraocular Lens (IOL) is implanted to replace the natural lens. After removing the cataract fragments, surgeons insert IOL through the same incision.
  • Closure and Recovery: The minimal incision heals automatically following the body’s self-healing process. In some cases, surgeons use adhesive or sutures to close the incision.

Laser-assisted cataract removal procedure is blade-free, risk-free, and promotes fast recovery. Patients expect to go home on the same day of surgery.

Difference Between Laser & Traditional Cataract Surgery

Laser cataract surgery offers multiple advantages over traditional cataract surgery, including greater precision and customization of incisions, improved accuracy in the capsulotomy, and enhanced lens fragmentation. However, it’s important to note that all cataract cases may not require laser assistance. Thus, cataract specialists and eye surgeons should determine the surgical technique.

Here are some key differences between traditional & Laser-assisted cataract surgery:  

  • Incision and Capsulotomy: In traditional cataract surgery, the surgeon manually creates the incision in the cornea and performs the Capsulotomy using a blade or a needle. On the other hand, in Laser cataract surgery, a Femtosecond laser is used to create precise incisions and perform the Capsulotomy, providing greater accuracy and potentially reducing the risk of complications.
  • Lens Fragmentation: In traditional surgery, the cataract is typically broken up using Phacoemulsification, which involves Ultrasonic energy. On the other hand, In Laser cataract surgery, the Femtosecond Laser is used to soften and fragment the cataract before the Phacoemulsification step. Therefore, the laser could make the cataract removal process more efficient and require less energy during Phacoemulsification.
  • Precision and customization: Laser cataract surgery allows for excellent accuracy on and customization of certain aspects of the procedure, including specific location, length, and depth of the incision. 
  • Surgeon’s Experience & Availability: Traditional cataract surgery has been performed for many years and is widely available. However, laser cataract surgery requires specialized equipment, training, and expertise. In addition, not all surgeons may have access to or be proficient in using laser technology in cataract surgery.
  • Cost: Laser cataract surgery is generally more expensive than traditional surgery due to the additional expenses associated with Laser technology.

Conclusion:

In conclusion, traditional and Laser cataract surgery are practical and widely practiced methods for removing cataracts and improving vision. In addition, traditional cataract surgery has a long history of success and availability, offering reliable outcomes for patients. On the other hand, with advanced Femtosecond Laser technology, cataract surgery provides additional benefits such as precise incisions, customized Capsulotomy, and efficient lens fragmentation.

Ultimately, the decision regarding the surgical approach should be made in consultation with an experienced ophthalmologist who can evaluate the specific needs and circumstances of the patient.

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