Download Refractive Laser-Assisted Cataract Surgery

Refractive Laser-Assisted Cataract Surgery – What Is It? by Quentin D. Falgoust, MD
Cataract surgery falls into two categories. For some, it’s a medical procedure in which the cloudy natural lens of the eye
is removed and an intraocular lens (IOL) is implanted, followed by basic refractive care, which means glasses. For others
- patients who want to function without glasses, or with less dependence on them (whether at distance or near) - it
becomes refractive cataract surgery. Patients who want refractive cataract surgery usually, but not always, choose a
premium IOL. Refractive Laser-assisted cataract surgery done in conjunction with a premium IOL gives the most
effective visual outcome due to its surgical precision.
How Does It Work?
Refractive Laser-assisted cataract surgery uses a femtosecond laser to perform surgical steps that were previously done
manually. Compared to the manual technique, laser-assisted surgery is the model of predictability and precision. At
ADVANCED EYE INSTITUTE, we are proud to offer access to this quality level of care for our cataract patients.
While manual cataract surgery is the most routinely performed surgery today, and generally has a safe and effective
outcome when performed by a skilled surgeon, it still requires the use of hand-held instruments. Your surgeon must first
make a two-step self-sealing incision through the cornea to gain access to the cataract. The surgeon’s goal is to make
these incisions precise, but he must use a hand-held blade to create them. He must also use a hand-held instrument to
create a circular opening through which to access the cataract in the lens capsule, which wraps the natural lens of the
eye. This opening is called a capsulotomy. In most cataract surgeries, the IOL is then placed inside this “capsular bag”,
and it is important to place the capsulotomy in an exact location, as well as maintain the integrity of this bag so that the
IOL can be positioned correctly within it.
During Refractive Laser-assisted cataract surgery your surgeon will use the laser to create both the two-step incisions
and the capsulotomy. Clinical studies have shown that this opening is approximately 10 times more accurate when
performed with the laser than by hand. The laser is able to perform the most challenging steps of a manual cataract
surgery.
Your surgeon can also use the laser for fragmentation of the cataract, enabling it to be removed more gently and with
significantly less ultrasound energy. Using less ultrasound energy will allow quicker visual recovery, causes less ocular
swelling or inflammation, and less incision disruption.
Depending on your vision before surgery, and your desired visual result after surgery, your doctor may recommend a
treatment plan that could include creating ultra-precise incisions in the cornea to reduce corneal astigmatism. Corneal
astigmatism is when the cornea is shaped more like a football than a basketball, and placing these astigmatism
correcting incisions allow the steep part of the cornea to ‘relax’ and become more spherical in shape. This is important
especially when placing a multifocal premium IOL, but can be equally important even with a monofocal (single-focus)
IOL.
Am I a candidate for the laser?
If you are a cataract patient, you are a candidate for Refractive Laser-assisted cataract surgery, unless there are preexisting ocular conditions that will affect your procedure. You must be able to lie flat on your back and motionless during
the procedure. You must be able to tolerate local or topical anesthesia. Your doctor will discuss your candidacy in more
detail during your cataract evaluation exam.
There are also out-of-pocket expenses associated with use of the laser, as health insurance only covers the basic costs
associated with traditional cataract surgery. Those who do not wish to invest out-of-pocket money in Refractive Laserassisted cataract surgery can still feel confident about the manual procedure when performed by our skilled and
experienced surgeons at Advanced Eye Institute.
Both Dr. Falgoust and Dr. Richard Arceneaux perform Refractive Laser-assisted cataract surgery, as well as traditional
cataract surgery and Lasik. To find out if you are a candidate, contact one of our offices to schedule an evaluation –
985/446-0506 or 985/879-2393, or visit us on the web at www.friendlyeyecare.com.