Cataract surgery undergoes a revolutionary change once again

Cataract surgery technique has now changed after two decades of conventional phaco. With the help of the Lensx Femto-second laser and live OCT guided imaging, a surgeon can perform the most challenging steps of cataract surgery with precision and ease. The laser thus provides patients with an absolutely blade-free, highly safe and a better alternative

What Is Cataract?

Cataract is a clouding of the natural lens of the eye, which prevents light from passing clearly through it, causing loss of vision, usually a result of ageing.

What is the treatment of cataract?

The only treatment of cataract is surgery. The cloudy cataract lens is removed and replaced by an artificial intraocular lens (IOL). 

ADVANTAGES OF FEMTO-LASER

High precision unmatched by human hands:  

The laser ushers in a new era of automation, enhancing the skills of the surgeon, making the most difficult steps of Phaco surgery simple and 100% accurate, thereby improving the safety and visual outcomes of cataract surgery. Imagine drawing a round circle with a computer guided printer and a human hand and one can understand the difference

Bladeless cataract surgery:

Since the laser is the cutting tool during the entire surgery, no blades or knives are used during the procedure, also earning it the nomenclature of bladeless cataract surgery. A computer controlled laser is a more precise and a better cutting tool than a hand held blade. For people who have a phobia for blades and needles working on such a delicate system as the human eye, this will come as a welcome relief.

Robotic cataract surgery:

A more precise name for the technique is computer controlled laser assisted surgery. However, since most of the critical surgical steps are automated and carried out at the press of a button, it is popularly referred to as Robotic cataract surgery

Improves vision better than present day surgery:

Conventional Phaco only addresses the problem of cataract, without having any impact on the pre-existing astigmatism (cylindrical power) due to abnormal corneal curvature. The femto-laser also corrects the pre-existing cylinder in a patient’s eye, using its astigmatic correction module (LRI) thereby resulting in a better visual outcome as compared to conventional Phaco.
Henceforth, cataract surgery is not just a procedure for visual rehabilitation, but an experience of enhanced visual outcome.

Safer than present day surgery:

Phaco is considered a fairly safe surgery; however, the femto-laser system further enhances the safety by improving the performance of a surgeon, and reducing the chances of human error. The computer controlled incisions made by the laser are more precise and accurate than manual incisions, in terms of depth and architecture, and therefore have better wound sealing and less chances of infections.

A basic platform for Advanced Technology (AT) IOLs:

Premium Intra-ocular lenses (IOLs) require a perfectly centered, round and fixed diameter capsular opening for best visual results possible only with Femto-laser

US –FDA approved

After completing clinical trials, receiving the CE mark, and US FDA approval, the femto-second laser cataract surgery machine is now available in India also.

Limitations of the procedure:

The procedure is not advocated in patients with poorly dilating pupils, and in those with advanced glaucoma. It is not the procedure of choice for patients with corneal opacities. It is as yet, not cleared for use in children

Technique:
The Femto-second laser is docked on the eye using a Patient Interface (PI). Live continuous 3-D OCT pictures are streamed on to the computer screen. Main incision, side port incision and Capsular opening are marked on the computer screen. Astigmatic control incisions if required are also marked. On a press of a button, the laser completes all the steps in approximately 55 seconds. The eye is undocked. The patient shifted to the main OT. The incisions are entered with a spatula. Since no blades are used to make the incisions, the procedure is referred to as the bladeless cataract surgery. The nuclear fragmented material is aspirated out and an IOL inserted. No sutures are required as the incisions are self sealing 

The Femto-second laser machine:
The name of the machine is the LenSx Femtosecond Laser System, being introduced by Alcon, USA. The laser is designed to predictably perform many of the most challenging aspects of traditional cataract surgery.

Cost of the procedure:
The cost of the procedure is 1.05 lakhs with a premium IOL like Acrysof IQ (Alcon USA).