Is Laser-Assisted Cataract Surgery Right for You? Are you planning to have cataract surgery? If so, you may have two surgical options:
  • traditional cataract surgery, and
  • laser-assisted cataract surgery
Traditional cataract surgery is one of the most common surgeries in the world. It is recognized as being safe and effective. Laser cataract surgery is not covered by most insurance plans. It costs more than traditional cataract surgery as well. In specific situations, it may provide some advantages. So how do you decide which type of cataract surgery to have? Here are some things you should understand about both kinds of cataract surgery. Talk with your ophthalmologist about which is best for you. Feel free to get another eye surgeon’s opinion as well.

How Is Traditional Cataract Surgery Done?
Phacoemulsification is the name for traditional cataract surgery. Your surgeon creates a small incision in your cornea by hand with a scalpel. They insert a small instrument through this opening. It goes behind your pupil where the eye’s lens sits in a capsule. Your surgeon creates a round opening in the capsule. Then your surgeon inserts a pen-shaped probe through that opening. The probe applies sound waves (ultrasound) to break up the cloudy lens. Then the surgeon suctions out the broken-up pieces. They replace your lens with an artificial intraocular lens (IOL). The incision is self-sealing and usually does not need stitches.

How Is Laser-Assisted Cataract Surgery Done?
A camera/ultrasound device is placed over your eye to map its surface. It also gathers information about your lens. The device sends the results to a computer that programs the laser. This tells the laser the exact location, size, and depth for incisions. The surgeon may use the laser to make the corneal incision and the opening in the capsule. They may also use energy from the laser to soften the cataract. An ultrasound probe breaks the lens into pieces and suctions them out. The surgeon then puts the IOL in the eye. Again, the incision usually does not need stitches.

To Whom Can Ophthalmologists Offer Laser-Assisted Cataract Surgery?
Medicare guidelines determine who can get this laser surgery. Only certain patients qualify for it. Your surgeon can offer laser-assisted cataract surgery if:
  • they find astigmatism during your consultation, and you want it corrected during cataract surgery. In this situation, the laser creates specific incisions in the cornea to reshape it. This corrects your astigmatism.
  • Your surgeon can also offer laser surgery if you choose a premium lens. For example, this may be a toric or multifocal IOL that corrects astigmatism. Laser cataract removal allows surgeons to see and map the lens capsule better. It also helps them to place the opening in the capsule more precisely. This allows for better centering of the IOL, which is important when a premium lens is used.
  • It can be offered off-label for patients with pseudo-exfoliation syndrome (PXF) Cataract surgery in PXF patients carries a significant risk of complications in the form of capsule rupture, vitreous loss, nucleus luxation, and IOL dislocation. PXF material involving most ocular tissues determines progressive weakening of the zonular ligament with consequent loss of lens stability.
Can You Have Laser Cataract Surgery if You Don’t Meet the Conditions?
If you don’t meet at least one condition, a surgeon cannot offer or charge for the laser surgery.

Which Type of Cataract Surgery Has a Shorter Recovery Time?
The recovery time for both types of surgery is the same. Some people can see clearly almost immediately. Others may find their vision clears within a week or two. It takes about 3 months to fully recover from cataract surgery.

What Benefits Does Laser Cataract Surgery Offer?
Using a laser allows the surgeon to make precise incisions in less time. It can improve accuracy and consistency. In some cases, the laser can provide more correction than traditional surgery. The laser can reduce the amount of ultrasound energy needed to soften the lens prior to removal. However, studies do not show that laser surgery results in fewer complications. Also, studies haven’t found that laser surgery provides better outcomes. Your outcome depends in large part on the skill and experience of your surgeon.

What Do You Want From Cataract Surgery?
Replacing a cloudy lens and wearing glasses for some things is perfect for many people. For others, getting the best possible vision without glasses is the goal. You and your surgeon can decide the best option for you based on your needs.