Cataract Surgery May Be Safer With Laser
Laser Pretreatment Softens Cataracts, Allows for Safer, Easier Removal, Researchers Say
Laser Cataract Surgery Requires Less Energy continued...
All had the femtosecond laser procedure in one eye and standard manual cataract surgery in the other.
Lens fragmentation involved using the laser to make the incision and split the lens into sections and soften it by etching cross-hatch patterns on its surface, prior to use of ultrasound and removal.
The laser-treated eyes required 45% less ultrasound energy to achieve cataract removal than the conventionally treated eyes.
Also, surgeons made 45% fewer movements in eyes that received laser pretreatment compared to manual standard surgery.
"Intuitively if we use less energy and fewer movements inside the eye, we will have fewer complications, less inflammation and swelling of the eye, and faster recovery of vision," Culbertson tells WebMD.
Because such problems are relatively rare, however, "we need thousands and thousands of patients to prove this," he says.
The laser pretreatment adds about five to seven minutes to the usual 10- to 15-minute cataract surgery, Culbertson says.
The study involved the most common types of cataracts, those graded 1- 4. Culbertson says that these findings may not apply to higher grade, harder cataracts.
Laser Cataract Surgery Causes Less Cell Damage
Packer and colleagues assessed laser cataract surgery in terms of loss of endothelial cells on the inside surface on the cornea, as counted after the procedure.
Packer consults for LensAR, which makes the laser used in the study.
"Endothelial cells are a barometer of the health of the eye," Packer says. They preserve the cornea’s clarity, and they don’t regenerate, he says.
When laser lens fragmentation was used in 225 eyes, there was no loss of endothelial cells, the study showed. In contrast, there was 1% to 7% cell loss in 63 eyes that received standard treatment.
Laser Cataract Surgery: Other Advantages
Other research has shown other advantages to laser surgery as well, Packer says.
"Incisions are always precisely the same. That's hard when we use our hands [to perform the surgery]," he says.
Also, the laser allows doctors to perform more precise, standardized capsulotomies, which is the opening and removal of part of the lens capsule to make room for the new lens. This reduces the chance that a lens will later become displaced.