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Traditional vs. Laser-Assisted Cataract Surgery

By Michael Cohen, MD | Ophthalmology 

Cataracts are an eye condition as old as time itself, becoming much more common as we ourselves get older. A clouding of the eye’s lens that blurs vision, cataracts affect more than half of all Americans by the time they reach 80, according to the National Eye Institute.

But the way cataracts are treated has evolved and improved with the advent of recent BLADELESS technological advances. In addition to traditional cataract surgery, a newer method employing laser energy has revolutionized treatment in the last several years.

As one of the few ophthalmologists in the Mount Kisco area that performs laser-assisted cataract surgery, I feel it offers another solid, safe, and effective option – with many advantages compared to the traditional approach – to the estimated 30 million people worldwide with cataracts.

The laser-assisted option will prove especially important since cataract surgery is one of the most common surgeries taking place in the United States, with 3 million Americans undergoing this procedure each year. But what’s the difference between traditional and laser-assisted cataract surgery? It’s important for cataract patients and their loved ones to educate themselves in order to make the best choice.

How Traditional Cataract Surgery is Done

The older approach to cataract surgery requires the doctor to make a tiny incision by hand on the side of the eye’s cornea to remove the cloudy lens. A small probe is inserted in the eye that breaks the lens into pieces using ultrasonic energy, and a second probe sucks out the pieces. Through the incision, an artificial lens is inserted and moved into place, and stitches may be used to close the cut.

How is Laser-Assisted Cataract Surgery Performed?

Laser-assisted cataract surgery doesn’t rely on the eye surgeon’s steadiness of hand, using special software instead to devise a surgical plan with 3-D images of the eye. This plan maps the location, length and depth of the cataract and uses a device known as a femtosecond laser to break the cataract into pieces. No stitches are necessary with laser-assisted cataract surgery, since the incision is self-healing.

Benefits of Laser-Assisted Approach

Compared to traditional cataract surgery, the laser-assisted approach offers a myriad of advantages. First, the use of a computer-guided laser means the surgical incision is up to 10 times more accurate than a corneal incision done by hand. The laser also requires half as much ultrasonic energy to dissolve the lens, and the computer makes the placement of the replacement lens more precise.

Recovery is also smoother after bladeless laser-assisted cataract surgery. With traditional surgery, common side effects include discomfort in and around the eye for several days afterward, along with blurred vision and the feeling of an itchy, sticky or gritty eye. After laser-assisted surgery, no pain is usually felt, since less trauma has been dealt to the eye.

Ongoing research continues to examine the short- and long-term results and benefits of laser-assisted cataract surgery compared to traditional surgery. But it’s looking pretty clear – pun intended – that the laser-assisted approach may lead to better outcomes for patients with this extremely prevalent eye condition. Laser-assisted cataract surgery is not currently covered by insurance and a nominal out of pocket fee may apply.