Introduction  

Laser-assisted cataract surgery (LACS) is an advanced technique that uses a femtosecond laser to remove cataracts. A cataract is a disorder where the eye lens becomes cloudy and loses its clarity. It causes blurred vision because incoming light is scattered and can’t be well focused on the retina. Cataract surgery aims at removing the cloudy lens and replacing it with an artificial one.

Laser-assisted cataract surgery improves the accuracy and consistency in the surgical process. It enables the eye surgeon to make very precise incisions faster. In some cases, LACS can give a higher degree of correction for refractive errors like astigmatism, compared to conventional cataract surgery.

LACS is an innovative bladeless technology that is less invasive. It provides computer guided control in making incisions and removing the cataract. The procedure is efficient and effective in the treatment of cataract. 

Laser-assisted cataract surgery also allows the surgeon to customize the procedure. He/she can design a computerized surgical plan that is specific to the patient’s eye map. It removes the guesswork from the process and delivers meticulous results. The patient’s eye is scanned for measurements. The results are translated into a personalized, restorative plan that is custom built to the individual.

It introduces a new level of sophistication in the preparation and performance of cataract surgery. The computerized mapping and 3-D measurements provide precise specifications for the technique to achieve outstanding results.

Purpose

he use of laser helps to improve the precision and reproducibility of:

  • Corneal incision
  • Anterior capsulotomy
  • Cataract and lens fragmentation

LACS may reduce the risks and improve the visual results of cataract surgery.

Laser-assisted cataract surgery also has special capabilities for the treatment of astigmatism. It can also be used in the accurate alignment of multifocal or extended-range intraocular lens (IOL) or other special lenses.

Preparation & expectation before Surgery

Laser-assisted cataract surgery needs detailed planning. The surgeon considers the anatomy of the patient’s eye using a camera/ultrasound imaging device. This process is referred to as visualization and involves 3D high-resolution imaging. 

It assesses and maps the anterior chamber depth, the pupil diameter and the thickness of the cornea and the lens. The type of lens fragmentation is chosen and the parameters for the structure, depth and location the corneal incisions are entered into the computer. The laser procedure is ready to begin.

The surgeon also reviews any medication the patient may be taking and advices on changes to be made either prior to or following the surgery.

It is important for patients to discuss their needs and expectations with the surgeon before the surgery. Some people don’t mind replacing a cloudy lens with a clear implant and wearing glasses for some activities. Others may want to achieve the best possible vision without glasses after cataract surgery.

Procedure

The patient’s eye is docked into the laser platform to stabilize it. The surgeon initiates the laser to perform the corneal incision and the opening in the lens capsule. Laser energy may be used to soften the cataract and to break the lens into pieces. He/she will then suction out the deteriorated lens and implant the intraocular lens. It restores clear vision again. Usually, the corneal incision does not need stitches.

After care, recovery, results

Recovery after laser-assisted cataract surgery is very quick. Most patients notice a clearer vision within 24 hours of the surgery. One should be able to resume most normal activities after a day two; all discomfort should be gone. The doctor can prescribe: 

  • Anti-inflammatory eye drops for inflammation 
  • Antibiotic medication to reduce the risk of infection 

The patient has to wear eyeglasses or an eye shield to protect the eye. One must also avoid pressing or rubbing on the eye while it heals.

Patients who have cataracts in both eyes may have the second surgery in a week or two.

It is important to note that recovery times may vary. Patients should talk to the surgeon in case of any concerns.

Risks & complications

The risks and complication of laser-assisted cataract surgery may include:

  • Itching
  • Eye discharge
  • IOL positioning
  • Mild discomfort
  • Slight hemorrhage 
  • Residual refractive error
  • Sensitivity to touch and light 
  • Incomplete anterior capsulotomy