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How Does Laser Cataract Surgery Work?

The use of lasers in cataract surgery is the most recent major advancement in cataract surgery. Laser cataract surgery offers optimal visual outcomes, minimizes risks, and shortens the recovery period after cataract surgery. For these reasons, we typically recommend laser cataract surgery over traditional cataract surgery at Beach Eye Medical Group.

The Evolution of Cataract Surgery

A common vision problem, cataracts have affected humans throughout recorded history. Due to their prevalence, it is not surprising that doctors and healers in ancient times sought ways to restore vision by removing cataracts from their patients’ eyes. The first documented cataract removal occurred sometime in the fifth century BCE – over 2500 years ago! These doctors knew that the lens of the eye needed to be removed once it had become clouded with cataracts. Removal was primitive and involved hitting the affected eye with a blunt object so that the lens of the eye would dislocate. Once the lens was removed, the patient would sometimes be able to see again, but their vision would always be severely impaired.

In 1748, a doctor in Paris performed the first surgical removal of a lens affected with cataracts. The surgery was performed by making an incision halfway around the cornea to allow for removal of the lens of the eye. By this time, doctors recognized that it was dangerous for the lens to break apart and migrate into the vitreous cavity, so the surgery was only performed in instances where cataracts had advanced to a stage that caused the lens to become hardened. In the 20th century, surgeons developed a technique that allowed for more precise and careful removal of the lens through a tiny incision. In 1987, phacoemulsification surgery was developed, which used ultrasound energy to break the lens into tiny fragments that could be safely suctioned from its capsule. The introduction of phacoemulsification marked the advent of modern cataract surgery and has helped it become the safe and effective surgery it is today.

While the methods for cataract removal advanced over the centuries, patients were reliant on thick glasses to see clearly after the surgery. It wasn’t until the development of artificial lens implants, known as intraocular lenses (IOLs), that cataract surgery could provide patients with improved vision without special eyeglasses. Today cataract surgery involves both the safe removal of the damaged lens and its replacement with an IOL to restore vision.

How Lasers Enhance Cataract Surgery

At Beach Eye, we use lasers to assist us in performing the majority of our cataract surgeries. Laser cataract surgery utilizes the same basic process as traditional cataract surgery, but involves the use of a laser to enhance the surgery and improve outcomes. This is how we perform laser cataract surgery:

  1. First, an advanced 3-D image of the eye is created. The surgeon uses this image to guide the entire cataract surgery with a femtosecond laser ensuring the most accurate, precise result.
  2. The first step is the capsulotomy, which involves removing just the front portion of the delicate capsule surrounding the lens of the eye. It is very important that the integrity of the capsule is preserved during this step, as it will house the IOL after it is inserted. When a laser is used for this step, accuracy and predictability of results are improved 10-fold compared to manual techniques.
  3. Once our surgeon has access to the lens, he uses the laser to break up the lens into tiny fragments so it can be safely removed from the capsule. Traditionally ultrasound energy was used to break up the lens, but this technique can occasionally cause a burn along the incision, which can negatively affect the outcome of surgery. It can also case corneal swelling. When a laser is used, it softens the cataract and lens before fragmenting it, requiring a much smaller amount of ultrasound energy to be used thereby reducing swelling and inflammation after surgery.
  4. In certain cases, the laser can be used to reduce astigmatism in the final step of the surgery. By addressing this common condition, many patients who undergo laser cataract surgery will be less reliant on glasses than they were before cataracts developed.

Since its introduction, laser cataract surgery has greatly improved the outcome and reliability of cataract surgery. We have seen the ways in which cataract surgery has evolved and improved over the years and are eager to see what comes next. Rest assured, whatever may come next, Beach Eye Medical promises to be at the forefront of the latest, cutting-edge technology in cataract surgery.

Astigmatism Presbyopia
Recommended IOL Toric lenses Multifocal IOL or Accommodating IOL
Revisions during surgery Limbal relaxation incisions may be made alone or combined with implantation of Toric lenses No additional revisions required
Glasses after surgery? Reading glasses may still be required Many patients will no longer require prescription lenses