By Andrew Velazquez, M.D. and Price Kloess, M.D., Alabama Vision Center
The advances in cataract surgery have been tremendous in the past decade with the advent of bifocal and astigmatism-correcting intraocular lenses (IOLs) and now, with the introduction of a new laser to perform the procedure. These technologies have given the over 1.5 million annual cataract surgery patients unprecedented options in vision correction, predictability and safety.
The LenSx laser is a femtosecond laser technology that is the same type of laser that brought new levels of safety, accuracy and predictability to the LASIK vision correction surgery.
Traditional cataract surgery is one of the safest and most effective procedures today with predictable outcomes. However, it is highly dependent on surgeon skill and experience. In traditional cataract surgery, we use a hand-held metal or diamond blade to create multiple incisions in the cornea (generally 2-4 depending on the amount of astigmatism). The goal is to create incisions that self-seal and do not require sutures. A circular opening is then made in the anterior capsule of the cataract. The cataract is then divided into smaller segments with an ultrasound probe to facilitate its removal. Finally, an intraocular lens is implanted to replace the cloudy natural lens.
If traditional cataract surgery is a 10 step procedure, the LenSx laser does the first six steps (including sectioning the cataract into smaller pieces) in 30 seconds. With LenSx, we create a precise surgical plan with a sophisticated 3-D image of the eye called an optical coherence tomography (OCT). This real-time, cross-sectional view of the cornea and cataract allows for placement of all proposed incisions simultaneously with the exact desired positions and dimensions based on the actual dimensions of the tissues in view. All of the critical incisions are made with a specific location, depth and length in all planes, and with the OCT image and the LenSx laser, they can be performed with unprecedented precision and consistency.
All of these factors are important not only for accuracy but also for increasing the likelihood that the incision will be self-sealing at the end of the procedure, which reduces the risk of infection. This reproducibility also enhances visual and refractive outcomes as IOL positioning is a significant factor in determining final vision.
Optical coherence tomography (OCT) is an imaging technology that helps us plan the location and depth of incisions made during a laser-assisted cataract surgery procedure. OCT scans offer high-resolution and even cross-sectional images, to make the cataract surgery as precise as possible.
We anticipate the demand for LenSx cataract surgery will grow. Our initial patients have had a good experience with excellent visual outcomes. Additionally, greater community awareness will result from current marketing campaigns. LenSx can be thought of as the “LASIK version” of cataract surgery. As LASIK brought vision correction to a new level of safety, predictability, patient acceptance and superior visual outcomes, so too will LenSx laser cataract surgery raise the bar for expectations and visual outcomes. The LenSx method of cataract removal is not covered by insurance so we predict that, as with LASIK, only a few eye surgeons in our area will make this a regular offering in their practices.
The LenSx laser is definitely the future of cataract surgery. Ultimately it is our patients who will be the beneficiaries of this amazing new procedure. We look forward to helping them see their best by offering this and other premium technologies.