Lasers help bring cataract surgery in focus

Exclusive to the Acorn group of newspapers

There are a number of advantages to using the laser in cataract surgery. Mainly, the surgeon can plan the exact size of the eye capsule opening that is needed for the replacement lens. With lasers, the doctor can also determine the exact pattern in which the old lens will be broken up.

Tests prior to the procedure include obtaining a colored image of the surface of the eye and measuring the length of the eye.

A detailed clinical slit exam is required to assess the thickness, color and hardness of the problem lens. Any weakness in the support of the lens or abnormalities on the lens capsule must be spotted.

This information leads to a plan of action which is entered into the laser software. Modifications can be programmed and, in difficult cases, a second opinion can be obtained.

Laser cataract surgeryis safe as it does not stress the lens capsule or its support. The same holds true in traumatic cataract cases where trauma weakens the support.

Use of the laser is beneficial in making openings in eyes with thick capsules such as those of children.

In people with white or red cataracts, the capsule needs to be stained manually to be visualized, and still it may be difficult to get a good view of the area. The laser overcomes this challenge as it employs imaging in real time and vertical cutting to avoid any traction on the zonular support system.

Acorn laser cataract surgery information

The opening in the capsule can be controlled by the laser down to a tenth of a millimeter. The laser consistently generates an opening of the desired diameter and a shape that is difficult to reproduce manually. An experienced laser surgeon will make a fully accurate opening. Sometimes the shape may be eccentric or oval.

A more circular, central and precise opening is best when implanting an artificial lens. When using the Restor and Tecnis brands, the openings are usually a tad smaller than for Crystalens.

Laser surgery for cataracts is equally helpful in wound management. A precise opening will allow entry and exit of instruments and insertion of the implant without undue stress on the wound. This prevents wound leakage at the end of the procedure and therefore faster healing.

Splitting of the lens by laser is done without any stress on the capsular bag or the zonular support system. Energy from the laser is delivered from the bottom towards the top, which allows gas generated by conversion of the lens material into plasma to escape, as well as allow the subsequent beam to work without interference from gas bubbles.

Sound energy, a commonly used procedure, can cause inflammation and affect the functioning of the cornea.

In dense cataracts, the bottom is difficult to perceive so the capsule can be accidentally ruptured. Real-time display with the ability to be precise and avoid the bottom of the bag becomes an advantage when using the laser for cataract procedures. Breaking apart a hard, afflicted lens can be time-consuming with traditional sound wave technology. Lasers decrease the time and energy required to accomplish the same task.

Further progress in laser technology is coming. One day maybe even robots will be able to do safe and effective cataract surgeries. For now, we must still rely upon the skilled hands of human surgeons.

For more information about laser cataract surgery, visit www.piineye.com or contact the Khanna Institute at (805) 230-2126.

 

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