Cataract is the opacification of natural clear lens. As a part of treatment, cataract has to be removed and replaced with an artificial intraocular lens. Cataract surgery is a process of removal of cloudy lens. Change is the only constant thing in this world. As the science advances, method for removal cataract is getting better and better. Veteran ophthalmologist had seen transformation from Intracapsular cataract surgery to extracapsular cataract surgery. They have witnessed first generation phacoemulsification machine & also the most advanced phaco machine with advanced fluidics. As the technology is taking leap towards next milestone, it has benefitted patients in terms of better visual outcome and surgeons in terms of ease of performing the skilled procedure.
Phacoemulsification is a procedure in which surgeon makes small incisions with help of blade to enter the eye and cataract is removed with the phacoemulsification probe. Surgeon uses ultrasound energy to dissolve cataract. Traditional phacoemulsification procedure is highly skilful surgery, very much dependent upon surgeon’s dexterity, experience and volume of surgeries one has performed.
In laser assisted cataract surgery, an advanced femtosecond laser replaces or assists use of a hand-held surgical tool for the following steps in cataract surgery:
Use of a laser can improve the precision, accuracy and reproducibility of each of these steps, potentially reducing risks and improving visual outcomes of cataract surgery.
These days, surgeon gives some relaxing incision (Limbal Relaxing Incision) over cornea to reduce corneal astigmatism (i.e. intrinsic glass number that patient may need after surgery due to curvature of cornea). During refractive laser-assisted cataract surgery, the OCT image can be used to plan laser LRI or AK incisions in a very precise location, length and depth. This increases the accuracy of the astigmatism-reducing procedure and increased the probability of good vision without glasses after cataract surgery.
Cost of laser cataract surgery is way higher than the conventional phaco procedure as the cost of femtosecond laser machine & its maintenance is huge. There are few conditions where laser assisted cataract surgery can’t be performed like small pupil and corneal scar etc.
It is important to put this newest technology into proper perspective. Routine phacoemulsification cataract surgery is very effective and successful at the hand of experienced surgeon. People who do not want to invest so much money in laser assisted cataract surgery can still feel confident about the routine phacoemulsification procedure. Experienced surgeon can deliver visual outcome at par with laser assisted cataract surgery at much lower cost.
Laser assisted cataract surgery seems to be appealing but its cost effectiveness is questionable. To sum up, its more accurate incision, capsulotomy and astigmatic correction may help patient to achieve goal of less dependence on glasses after cataract surgery but at a higher price. However, in the hands of an experienced surgeon results with the routine phacoemulsification are even better that too at a fraction of a cost.
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