For as long as optometry has existed, we’ve attempted to treat vision loss due to cataracts. As the eye’s natural lens ages, it becomes cloudy. This makes it difficult to see at night and in the presence of bright light sources, which makes driving and other activities prohibitively dangerous. The damage to a natural lens is irreparable.
Modern cataract surgery, or phacoemulsification, involves the extraction of the natural lens and implantation of an artificial lens, which restores the patient’s sight. Traditionally, this has entailed making a tiny incision in the eye, emulsifying the lens, and aspirating it from the eye before implanting its replacement. Advances in laser technology have obviated the scalpel, making for a safer procedure, albeit one with some drawbacks. We’ll look more closely at the benefits and disadvantages of laser cataract surgery.
Higher Precision, Lower Anxiety
Automating extraction by turning it over to computer-aided lasers increases precision beyond the capabilities of human hands. Before the procedure, the ophthalmologist will use a camera and sophisticated computer programs to draw the eye. From this information, the laser will know exactly where to cut and how deeply. Patients, who rarely undergo general anesthesia for these procedures, may feel more relaxed knowing that a laser is doing the cutting.
Less Ultrasound, Fewer Complications
A major complication of traditional phacoemulsification procedures comes from the ultrasound used to emulsify and break up the natural lens before removal. The heat that ultrasonic waves generate can do collateral damage to the lens capsule, which holds the lens in place. This part of the eye, in turn, can opacify just as the lens once did, eventually requiring additional surgery to resolve. The ultrasound can also damage the incision that preceded it, causing discomfort and slower healing. The heat of the laser can reduce the ultrasound necessary to emulsify and remove the eye, meaning fewer complications.
For patients, there are few downsides to laser cataract surgery other than the higher costs to account for the more advanced technology. The ophthalmological community has a wider view of the benefits and disadvantages of laser cataract surgery. Just as the patients see higher costs associated with this surgery, so too do practices, which must make sizable investments in the necessary technology. Costs of disposable equipment associated with the surgery can escalate beyond those of traditional surgery. Moreover, some ophthalmologists believe that relying on lasers to perform phacoemulsification encumbers the professional development of new eye doctors, who should be able to demonstrate the ability to remove cataracts with traditional ophthalmic supplies and without laser aid. While laser cataract surgery has improved outcomes for patients and brought new business to practices, perhaps we shouldn’t lose sight of the fundamentals.