Laser cataract surgery – also called laser-assisted refractive cataract surgery (ReLACS) – is an advanced type of cataract surgery that uses femtosecond laser technology to deliver a new level of precision and accuracy to specific steps in cataract surgery that were usually performed using cataract surgery instruments set.
These steps include:
- The corneal incision
- The anterior capsulotomy
- Fragmentation of the lens and cataracts
The increased precision, accuracy, and reproducibility of each of these steps, when performed with a laser, may reduce some risks and improve visual outcomes from cataract surgery.
- The corneal incision
- The first step in cataract surgery is to make an incision in the cornea.
During conventional cataract surgery, the surgeon uses a hand tool with a metal or diamond blade to create an incision in the area where the cornea meets the sclera. This incision allows the surgeon to access the inside of the eye to dislodge and remove the cataracts, which are cloudiness of the lens, just behind the pupil.
Then, an intraocular lens (IOL) is inserted and implanted, to replace the cloudy lens. The corneal incision is made in a special way, so that it heals itself after surgery, without the need for stitches.
During cataract surgery, the surgeon creates an accurate surgical plan for the corneal incision using an advanced 3-D image of the eye called OCT (Optical Coherence Tomography).
The goal is to create an incision at a specific location, depth and length at all levels, and with the OCT image and a femtosecond laser, the surgery can be performed accurately without the experience variable of the patient.
This is important not only for accuracy, but also to increase the likelihood that the incision will heal at the end of the procedure, which reduces the risk of infection.
The lens is surrounded by a very thin transparent capsule. During cataract surgery, the front of the capsule is removed in a procedure called an anterior capsulotomy. This step gives the surgeon direct access to the cloudy lens (cataract).
It is very important that the intact residue of the lens capsule is not damaged during cataract surgery because it is used to hold the artificial lens in place for the rest of the patient’s life.
In traditional cataract surgery, the surgeon creates an opening in the capsule with a small needle, then uses the same needle or forceps to tear the capsule in a circular motion. .
In laser cataract surgery, the anterior capsulotomy is performed with a femtosecond laser like the type used during LASIK vision correction surgery. Studies have shown that laser capsulotomies improve precision and reproducibility.
Studies have also shown that laser capsulotomies help to better center the intraocular lens, the positioning of which is an important factor in determining final visual results.
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