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Femtosecond Laser Cataract Surgery

Femtosecond Laser Cataract Surgery

Dr. Hesham Lakosha and the Halifax Eye Institute are the first in Atlantic Canada to offer Laser Cataract Surgery with Catalys™ Precision Laser System. This blade-free technology is considered by the ophthalmic community to be the most significant advance in cataract surgery since phacoemulsification was introduced more than 50 years ago.

Laser cataract surgery at the Halifax Eye Institute involves utilizing a sophisticated femtosecond laser to complete many of the critical steps of the operation that were previously completed manually with a blade or other hand-held instrument. These steps include all the corneal incisions, astigmatism control or reduction procedure, a central opening in the anterior capsule and fragmentation of the cataract. Using a laser to complete these steps enhances precision, accuracy, and safety during the cataract operation.

The laser cataract surgery procedure is guided by real-time, intraoperative OCT imaging which provides higher resolution than an MRI. This allows the procedure to be totally customized to the unique characteristics of the patient’s eye.

Eye surgeons all over the world believe that laser cataract surgery will eventually replace traditional cataract surgery, in the same way that blade-free LASIK has replaced LASIK with a blade at all premium laser centres.

All patients at the Halifax Eye Institute will have a choice between traditional cataract surgery and laser cataract surgery. There is an extra charge above MSI for advanced technology implants as well as for astigmatism reduction or control.

Laser cataract surgery has a number of unique advantages over traditional cataract surgery:

Better self-sealing incisions with less chance of leakage

The laser precisely creates all the necessary incisions in the cornea. Unlike those made by a hand-held blade during traditional surgery, the laser incisions have a unique architecture and a more precise width that allows them to seal better.

More accurate reduction of astigmatism and enhanced comfort

The laser incisions to reduce astigmatism are created at a precise length and depth based on intraoperative imaging using an OCT (optical coherence tomography). An OCT provides higher resolution than an MRI. The incisions are created below the corneal epithelium, which provides enhanced comfort. Limbal relaxing incisions with traditional surgery are performed with a hand-held blade.

Potential for better quality of vision

This is because of a more accurate final resting position of the intraocular implant. The laser can create a perfectly round central opening in the anterior capsule of a specific size. The capsule opening can be centered over the visual axis. The intraocular lens is held in place with the remaining capsule. With a more precise capsule opening there is less chance that the intraocular implant will vault forward, backward or be tilted. This has been shown to result in better quality of vision with a reduction in higher-order aberrations.

Potential for clearer vision early postoperatively

The laser is used to fragment or break the cataract into small pieces before being removed with ultrasound. Approximately 95 percent less ultrasound energy is required to liquefy and remove the cataract; reduced energy is safer for the long-term health of the corneal endothelial cells and may lead to clearer vision in the early postoperative period.

How is bladeless laser cataract surgery performed?

Pending approval, the laser cataract surgery procedure at Halifax Eye Institute will proceed as follows:

Anaesthetic drops are instilled into the eye.

You are taken into the Laser Cataract Suite.

The laser is utilized to make the corneal incisions, reduce or control the astigmatism, create a circular opening in the anterior capsule of the cataract and fragment the cataract.

Your eye and lids are cleaned with a disinfectant solution.

A sterile drape, with a small opening for the eye, is placed over your head and body.

A small speculum is used to keep your eyelids from closing.

An ultrasonic probe that vibrates rapidly is used to liquefy the cataract that has been previously fragmented with the laser. Typically 95 percent less ultrasound energy is utilized as compared to traditional surgery.

An aspirating device is used to remove the contents of the cataract. A thin membrane referred to as the capsular bag is left intact.

An intraocular lens is folded and inserted through the micro-incision into the capsular bag.

An antibiotic is placed into the eye to prevent infection.

You are brought to the recovery room where you will rest before being discharged.