Brighter Days: Laser Advances Cataract Surgery

Laser surgical technology for removing cataracts is relatively new, which surprises many patients of ophthalmologists.

Laser technology for treating a host of eye conditions have been around for decades, but when it comes to the precision-required cutting necessary for treating cataracts, a specialized instrument called the femtosecond laser is less than two-years old.

More cataract patients are opting for this latest procedure at the Baptist Eye Surgery Center in Sunrise, Florida. The good news is that even traditional cataract surgery is safe and generally produces excellent outcomes, said Marvin Greenberg, M.D., eye surgeon and one of the ophthalmologists at the Broward practice, acquired recently by Baptist Health South Florida.

Nearly 60 percent of the Center’s patients are treated for cataracts. By age 80, more than half of all Americans either have a cataract or have had cataract surgery, according to the National Institutes of Health. Cataracts are essentially a buildup of protein in the lens of the eye that clouds vision by preventing  light from passing clearly through the lens.

“With traditional or femtosecond laser surgery, and lens implants, we can turn back the clock for a patient, restoring vision potentially to what it was when they were kids,” Dr. Greenberg said.

He believes this improvement to  cataract surgery, one of the most common operations in the United States, ultimately could impact the lives of millions of older people.

Traditional cataract surgery involves making an incision the size of a pencil tip in the cornea with a microscopic blade, opening the thin skin that surrounds the cataract with a hand-held instrument, then breaking the cataract into tiny fragments with ultrasound waves.

The fragments are vacuumed out through the tiny opening and an artificial lens, called an intraocular lens, is inserted, replacing the clouded, natural one.

The femtosecond laser makes precise incisions and contributes to providing patients with the best possible vision.

“It is bladeless and extremely precise and accurate,” Dr. Greenberg said.

Like traditional cataract surgery, the laser method, approved by the Food and Drug Administration, is low-risk, highly effective and essentially painless.

“Laser-assisted surgery is another way to make cataract surgery better, with less risk, and incrementally improve results that will take it to the next level,” said William Trattler, M.D., one of eight ophthalmologists using the femtosecond laser at the Medical Arts Surgery Center at Baptist Hospital.

Dr. Trattler says anyone with a cataract is a candidate for this procedure, which takes between 25 and 40 minutes, including setup time, and requires only mild IV sedation during a portion of the procedure.

The laser, guided by sophisticated imaging technology that helps plan the location and depth of incisions, allows for more precision. On average, ophthalmologists at the Medical Arts Surgery Center at Baptist Hospital perform about 50 of these operations monthly.

“This technology can result in the intraocular lens ending up in a more centered position following implantation,” Dr. Trattler said.

The laser also can be used to make extra incisions in the cornea to decrease astigmatism, which, when left untreated, results in less crisp vision. By treating the astigmatism during surgery, patients can potentially become less dependent on glasses.

Finally, the laser breaks up and softens the cataract. In both methods, the surgeon inserts an ultrasound instrument into the eye to remove the fragments. But laser treatment requires less ultrasound energy.

“So there’s potential for less swelling of the cornea and a patient can achieve faster visual recovery,” Dr. Trattler said.

Francisco Mariategui, a Miami import/export company executive, was recently diagnosed with cataracts in both eyes. After surgery on his right eye, he saw dramatic improvement in his vision.

“I was so impressed that I asked to speed up the surgery date for my other eye,’’ said Mr. Mariategui, 53.

Dr. Trattler agreed and performed the second surgery a week after the first. In addition to removing the cataracts, Dr. Trattler inserted a special astigmatism-correcting lens in Mr. Mariategui’s right eye. He used the laser to help center the lens, which makes it more effective.

“Now I can watch TV, read and use the computer without glasses,” Mr. Mariategui said. “Everything is so clear.”

Tags: cataracts, femtosecond laser