Lasers in Cataract Surgery
By Jeffrey Martin, MD
Published on March 31, 2010
Many of our Long island cataract patients assume that cataract surgery is performed with laser. They think that because cataract surgery techniques have become more modern in recent years, that it must be performed with a laser. However, the most advanced way to perform cataract surgery is with gentle computer controlled ultrasound called phacoemulsification.
Through a small incision, the "phaco" hand piece is used to break up and remove the cloudy or defective lens of the eye. This cloudy lens is like a grape. We peel an opening in the skin of the grape and then remove the fruit. A new intraocular lens implant or IOL is placed in the skin of the grape or the capsule. Since the opening in the capsule is smaller than the implant itself, it remains stable in the capsule for the rest of your life. Jeffrey Martin, MD, performs cataract surgery without stitches, needles around the eyes, or even an eye patch in most cases. We use eye drop anesthesia and IV sedation for comfort.
Months after cataract surgery, the capsule that holds the implant can become hazy. This can cause the vision to become blurred. We do use a laser called a Yag laser to gently remove the central part of the cloudy capsule. If this is necessary, our patients are able to return to normal activity right away. About 30 percent of patients that have cataract surgery will need a Yag Capsulotomy. Sometimes a cloudy capsule is called posterior capsule opacity and sometimes it is called a secondary cataract. Dr. Martin feels that calling it a secondary cataract is confusing for our patients because a cloudy capsule has nothing to do with cataract formation.
Lasers are currently being studied for specific tasks during cataract surgery. Certain steps of cataract surgery like incision formation and the opening of the front of the capsule might be easier and more accurate using a laser. The future of cataract surgery might include lasers for precision, but at this point, cataract surgery is done using ultrasound.