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In The Media – HOAG Hospital Magazine

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Samir Shah, M.D.

Q: Can cataract surgery be performed by laser?

A: Cataract surgery is one of the most common surgeries in the United States, and can be performed both traditionally (by hand) and by laser. Laser cataract surgery has been shown to significantly improve accuracy and precision of corneal incisions and the capsulotomy. Laser cataract surgery is gentler on the eye because less energy is required to remove the cataract compared to traditional cataract surgery. This can help reduce post-operative recovery time.

In order to understand specifically how laser cataract surgery may be beneficial, it’s important to understand what a cataract is and when surgery is typically performed.

A cataract is a clouding of the natural lens of the eye that eventually results in blurry and/or decreased vision. Cataracts require treatment when visual impairment begins to interfere with your daily life such as difficulty seeing street signs, glare, difficulty reading or watching TV. The only way to treat a cataract is through surgery. There are no clinically proven methods to reverse the progression of cataracts.

During cataract surgery, the natural lens of the eye is removed and an artificial lens or an intraocular lens (IOL) is placed in the eye to restore vision. Surgery takes less than half an hour and is usually performed in an outpatient setting. A typical cataract surgery includes the following steps:

  • Anesthesia – Anesthetic eye drops are applied to numb the eye and prevent discomfort.
  • Corneal incisions – Incisions are created in the cornea to provide access to the lens capsule and allow insertion of surgical instruments. Incisions can also be made to reduce astigmatism.
  • Capsulotomy – A circular incision is made on the surface of the bag that houses the lens.
  • Break up and removal of the lens – Phacoemulsification is a method using ultrasound energy to break the lens into tiny fragments that are gently sucked out of the eye.
  • Irrigation and aspiration – After the bulk of the cataract is removed, small remnants of cataract material are aspirated out of the eye.
  • IOL insertion – The IOL is folded and carefully inserted through the capsulotomy opening into the bag where it gently opens and settles into its functional position. Various IOL’s are available including standard monofocal IOL’s as well as premium/lifestyle IOL’s that can significantly reduce or eliminate dependence on glasses and contact lenses.
  • Finalizing the procedure – The incisions are sealed and antibiotic eye drops are applied.

In traditional surgery, these steps are performed manually with blades and needles by the surgeon. However, in laser cataract surgery, a highly-accurate, computerized laser assists the surgeon in performing some of the critical steps of the procedure. Specifically, corneal and astigmatic incisions, capsulotomy, and the break-up of the lens are all steps that can be performed by laser, making the procedure blade-free! Additionally, the laser provides optical coherence tomography cross-sectional imaging of the eye to help guide your surgery.

Overall, cataract surgery is a highly successful procedure that can restore clear vision. If you have been recently diagnosed with or think you may have cataracts, it is important to schedule a consultation with your ophthalmologist to discuss the best treatment options for you.

Samir A. Shah, M.D., M.S., F.A.C.S. is a board-certified, surgical ophthalmologist with Beach Eye Medical Group in Huntington Beach. Dr. Shah is a Diplomate of the American Board of Ophthalmology, a member of the American Academy of Ophthalmology, the American Society for Cataract and Refractive Surgery, the Cornea Society, and the California Academy of Eye Physicians and Surgeons.

To read the Q&A on the HOAG website, click here

Written by Dr. Shah