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What is Laser-Assisted Cataract Surgery?

A cataract is the clouding of the eye’s natural lens. It causes blurry vision and occurs usually due to aging. Laser-assisted cataract surgery is the removal of the cloudy natural lens using a laser and replacing it with an artificial intraocular lens (IOL) implant to restore normal vision and treat the cataract. Intraocular lenses are small, clear artificial lenses that are implanted permanently inside the eye to restore focus after removal of the eye’s natural lens during cataract surgery. Laser-assisted cataract surgery is a safe and effective option that results in better healing and fewer complications than traditional cataract surgery, which utilizes a scalpel. The type of laser employed in laser-assisted cataract surgery is called a femtosecond laser.

Indications for Laser-Assisted Cataract Surgery

Laser-assisted cataract surgery is mainly indicated for the treatment of cataracts. A cataract is a condition that causes clouding of the lens in the eye, resulting in blurry vision. The lens is situated behind the iris, the dark portion of the eye, and is not visible. The lens is mostly made up of water and proteins. These specific proteins provide the lens with its transparent structure. Any structural change in these proteins can alter the clarity of the lens and negatively impact vision. The lens becomes cloudy when a cataract occurs and is seen as a white cloudy ball in the center of the iris.

Preparation for Laser-Assisted Cataract Surgery

In general, pre-procedure preparation for laser-assisted cataract surgery includes:

  • A review of your medical history and routine diagnostic tests
  • A thorough eye exam to evaluate the overall health of your eyes and to study the shape and features of the eye in general
  • A measurement of the curvature of the pupils and cornea as well as the thickness of the cornea
  • A discussion about any medications or supplements you may be taking as some can complicate your cataract surgery
  • Informing your doctor of any recent illnesses or other medical conditions you have, such as diabetes or heart disease 
  • Refraining from eating or drinking at least 6 hours before the procedure. If you are on regular medication for conditions, such as high blood pressure, diabetes, or heart disease, you may take it with a sip of water.
  • Arranging for someone to take you home after the procedure
  • Signing an informed consent form after the pros and cons of the  surgery have been explained

Procedure for Laser-Assisted Cataract Surgery

Laser-assisted cataract surgery is a minimally invasive surgery performed on an outpatient basis, meaning you can go home the same day. In general, the procedure involves the following steps:

  • Your surgeon will first numb your eye with anesthetic eye drops.
  • An eyelid holder will be placed on your eye to prevent the eye from blinking.
  • A customized surgical plan is created with 3-D imaging of your eye. The 3-D imaging allows your surgeon to accurately map out the unique features of your cataract and eye.
  • Your surgeon will then use a femtosecond laser to make an incision in the outer layer of the eye to access the eye’s natural lens.
  • This is followed by the breaking up of the cloudy eye lens into small pieces using the laser.
  • A suction is used to gently remove the broken cloudy lens pieces from the eye.
  • An intraocular lens appropriate to your needs is then carefully inserted behind the iris and pupil in the same place your natural lens had occupied.
  • The incision in laser cataract surgery usually does not need stitches since it is tiny.

Postoperative Care and Recovery

Your doctor will provide a series of postoperative instructions to be followed for a defined period. These include:

  • You will be prescribed steroid and antibiotic eye drops for a few weeks to minimize the risk of infection and inflammation.
  • You should wear a protective eye shield for at least a week at night or while napping to protect the eye and prevent rubbing it in your sleep.
  • Avoid strenuous activities and exercises for a defined period so that there is no stress on the eye as it heals.
  • Keep away from dusty environments and avoid splashing water into your eyes to reduce the risk of irritation and infection.
  • Avoid hot tubs or swimming and close your eyes while bathing or showering for a week or two.
  • You should wear sunglasses to protect your eyes while outdoors.
  • Do not drive until cleared by your ophthalmologist.
  • You should be able to return to work or your normal daily activities in a few days.
  • A follow-up appointment will be scheduled to monitor your progress.

Risks and Complications

Some of the potential risks and complications of laser-assisted cataract surgery include:

  • Bleeding
  • Infection
  • Redness
  • Swelling
  • Retinal detachment
  • Displacement of the intraocular lens implant
  • Remote chance of vision loss

Benefits of Laser-Assisted Cataract Surgery

Some of the benefits of laser-assisted cataract surgery over traditional cataract surgery include:

  • Precision and safety
  • Needle and blade-free
  • Intraocular lens stability
  • Faster surgery
  • Faster recovery time
  • Optimized visual outcomes