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Laser Cataract Surgery

The ophthalmologists and eye doctors at Slade & Baker Vision performed the first laser cataract surgery in the United States on February 25, 2010, with the LenSx® femtosecond laser.

While traditional (manual) cataract surgery is considered to be one of the safest and most successful procedures performed in medicine, laser cataract surgery has significantly improved the precision of several of the most critical steps in cataract surgery.

With laser cataract surgery, the doctors at Slade & Baker Vision will customize your procedure to your eye’s unique characteristics, resulting in better visual outcomes while potentially making cataract surgery even safer.

In addition to using the LenSx femtosecond laser to accomplish many of the surgical steps that were traditionally performed by hand, we offer the best and latest innovations in cataract surgery, such as IV-free anesthesia and no-stitch, micro-invasive surgery.

How is Laser Cataract Surgery Done?

Laser Cataract Surgery is performed in a fully certified, dedicated eye surgery center.  The precise, reproducible steps performed by the laser means more precision, less ultrasound trauma to the eye, and more predictable visual results, which are especially important with Advanced IOLs.

The laser makes incisions in both the cornea and the front portion of the lens capsule, creating an opening called a capsulotomy. Studies have shown that less than 10% of manual capsulorhexes, which are made with a bent needle or forceps, have been able to achieve the same accuracy that is produced with Laser Cataract Surgery.

In order to remove the cataract, the lens must be divided into manageable sections. This critical step is also performed by the laser, which causes less stress to the delicate fibers surrounding the capsular membrane that hold the lens in place.

Laser fragmentation (left) is more precise and breaks up the lens with less ultrasound energy than manual fragmentation (right).

Laser fragmentation (left) is more precise and breaks up the lens with less ultrasound energy than manual fragmentation (right).

After Laser Cataract Surgery

You will be released soon after the procedure to go home and relax. Your eye will not be patched, and typically patients are able to see improvement in their vision almost immediately. Complete visual recovery varies from patient to patient, but most patients return to typical daily activities within a day or two.

If cataracts are present in both eyes, the second procedure may be scheduled within days of the first eye. Serious complications are extremely rare, but because it is surgery there are potential risks involved. Our counselors at Slade & Baker Vision will provide you with additional information about the risks associated with cataract surgery and answer any of the questions you may have.

Laser Cataract Surgery FAQ

Stephen Slade MD: You know, with cataract surgery it’s a little different from having LASIK or having PRK. With LASIK and PRK, if I decide I want to wait, then, I can wear glasses and contacts and likely still see 20/20. With a cataract, by definition, something’s clouding my vision that glasses won’t fix. So how long do you want to wait? Now, even so, cataract surgery is elective surgery. We always tell patients it’s nothing to be apprehensive about because it is such good surgery. And the safety record is so good. The risks are there, and real, but low. And with laser cataract surgery, our safety results are even better.

So it’s nothing to be apprehensive about. Luckily it’s also something you don’t have to rush into. You just won’t see as well as you could, with anything, until you have the cataract fixed. The cataract won’t damage your eye by being in there. It’s not going to, you know, damage structures. And, you know, you can, you know, take your time. Typically you could have it done next week, next month, or even next year.

But the vision will get worse, typically, as time goes on. And it won’t get better. So when you get to the point where you can’t do the things you want to do, whether it’s driving at night, reading, seeing the golf ball at a zillion yards, or whatever you were used to doing and you can’t do now. Then that’s the time to start thinking about having cataract surgery.

To be evaluated, see what your options are and then make up your decision. It’s elective surgery. The decision is yours. We can provide the information, there’s no rush. You just won’t see well, typically, until you have it fixed.

Stephen Slade MD: Standard cataract surgery is what we’ve done for years and years. It’s taking the cataract out, and it’s a wonderful technique. It’s taking the cataract out through a tiny incision, with an ultrasonic needle. That being said, the amazing advance that we have pioneered, is laser cataract surgery. A lot of people have always thought that we do cataract surgery with a laser. I have to tell people that every day, “No, it’s not done with a laser.” We do use this little ultrasonic needle, but that’s been going on for about 30 years.

Laser cataract surgery is actually using a laser, where there is no cutting on the eye, with metal blades. It’s using the laser to do about half of the steps of cataract surgery. It’s a far more precise way to make the opening into the lens, without having to use a manual technique to make that opening. It’s a no-touch technique to actually break apart and soften the lens so that it can be removed more easily.

It shortens the time that we spend inside the eye, and it gives us a more precise way of doing all of these different things to the eye. So, in our experience with it, it adds a lot of different safety factors, and it adds precision.

Stephen Slade MD: The laser can’t directly remove things from the eye. What it can do is make incisions in the eye. It can make all of the openings into the lens, and it can break up the lens. It can get it softened. It can get it ready to be taken out, but will still use, in most people, the ultrasound to remove the lens fragments.

So I don’t think it’s going to make ultrasound go away. In fact, I think the real clever physicians will be the ones that best blend the laser cataract surgery with the techniques of ultrasound so that we use, again, the laser sort of to do the first half of the surgery. And then the ultrasound, optimized to the laser, to do the second half of the surgery in a quicker, faster way. For example, we have found with the laser, we’re able to use less ultrasound. We have found with the laser first, that we do less manipulation of the eye. We spend less time in the eye.

We use less ultrasound. And the eye actually winds up in a healthier state. Because the less we do, typically with eyes, the better. So they actually work beautifully together. The laser does the first half. We use the ultrasound and the surgeon to do the second half. And in our experience, we’re ending up with a faster, more precise, more predictable, safer surgery that leaves the eye more intact. That leaves the eye alone more and is gentler.

A kinder, gentler approach to eye surgery. Which can translate to better results. We’re seeing people that have a more precise result. They’re seeing better, faster, quicker, more accurately. We’re very pleased that our visual results are even better with the laser.

Traditional cataract surgery is all done by hand with microsurgical instruments. Laser cataract surgery involves doing some of these steps with the geometric precision of the laser, which is more precise and reproducible.

These steps include opening the natural lens capsule, dividing the cataract into pieces for low-energy removal, and corneal incisions commonly used to reduce post-operative astigmatism and improve the accuracy of the unaided post-operative vision.

Not everyone is a candidate for laser cataract surgery, and we highly recommend a consultation for a personalized surgical plan. “One size fits all” vision approaches are a thing of the past.

The factors that make someone a medically good or poor candidate for laser cataract surgery include the presence of and location of corneal scars, history of certain kinds of eye surgeries or trauma in the past, and the anatomy of the conjunctiva, or the white part of the eye, and its underlying structures. No one has the same fingerprint or eyes!

Many people have improved vision (without the help of glasses/contacts) after modern cataract surgery with Dr. Slade than they have ever had before!

However, it is important to realize that no one can guarantee to be glasses-free after surgery. In general, taking a vision correction approach to cataract surgery (which includes the use of the laser and possibly astigmatism correcting and/or range of vision intraocular lens) allows for far better glasses-free vision than would be achievable without these technological and optical advances.

On the day of surgery, you will arrive at the surgery center and check-in. You will meet your nursing and anesthesiology teams, who will help keep you comfortable during your procedure.

You’ll have the chance to read over the informed consent documents.

Prior to surgery, you’ll meet with Dr. Slade to re-visit your surgical plan and have any of your questions answered.

The laser portion of the procedure comes first, after which Dr. Slade will remove the cataract fragments, polish and prepare the natural lens capsule for receiving your new intraocular lens (IOL), place the new IOL into the appropriate position and orientation, and ensure that the eye is well sealed (more than 99% of the time without any stitches).

Laser Cataract Surgery Reviews

Bladeless Cataract Surgery

The LenSx® laser approach – A New era in Refractive Cataract Surgery

Bladeless computer-controlled laser approach to cataract surgery

LenSx Laser - Putting the Future in Motion

If you are experiencing the onset of cataracts you know how difficult seeing can be. You may be struggling with night vision or you might not be able to tell the difference between pairs of socks. You may even have a sensitivity to sunlight. Fortunately, cataract surgery can help you to regain what you’ve lost, both in terms of your vision and your quality of life. Now, a technological breakthrough is available for use in cataract surgery.

Our eye surgeons will be among the first practices in the United States to have this breakthrough technology. When you choose to have your surgery performed with this LenSx® laser, you’ll enjoy a truly innovative solution that allows for customization in cataract surgery.

A bladeless, computer-controlled laser allows the surgeon to plan and perform your surgery to exact individualized specifications, not attainable with past cataract surgery methods. With the LenSx® laser, you can move forward with confidence knowing that you’ve chosen the most advanced technology available for this life-changing procedure, one that enables a customized cataract surgery experience.

Introducing LenSx® Laser Technology

LenSx® laser offers you a precision-based solution for cataract surgery. A bladeless, computer-controlled laser surgery planned and performed to exact individualized specifications, not attainable with other surgical methods.

Your eyes can be compared to snowflakes! While all human eyes share the same basic anatomical structure, every eye is just a bit different in terms of size, depth, the curvature of the cornea, and other key features. Which is why every eye must be carefully measured and mapped prior to cataract surgery.

While these measurements have been routinely performed prior to surgery, the LenSx® laser uses a range of highly-advanced technologies – including integrated optical coherence tomography (OCT) – to capture incredibly precise, high-resolution images of your eyes. These images – and the measurements and data they provide – are then used to plan and perform surgery to exacting specifications not attainable with traditional surgery.

Bladeless cataract surgery is performed in our in-office surgical suite and does not take any longer than traditional cataract surgery. You will most likely be in surgery for 20-25 minutes. Like traditional cataract surgery, you should arrive about an hour prior to surgery. Upon arrival, you will be given a mild sedative to relax. Although the surgery takes only minutes, plan to spend 2 to 3 hours at the center for the preoperative steps and for recovery.

The LenSx® laser provides patients with computer-controlled precision as it automates some of the most challenging steps of refractive cataract surgery. The laser replaces the traditional hand-held blade to optimize all incisions for enhanced, reproducible surgical performance. This breakthrough technology provides the surgeon with real-time three-dimensional visualization for true customization of your lens replacement procedure.

In addition to using the femtosecond laser to do many of the surgical steps traditionally performed by hand, our doctors still use many of the best innovations in cataract surgery, such as drops, only anesthesia (no shots), sutureless incisions through the clear cornea and foldable intraocular lenses. These advances allow us to use the smallest possible incision, approximately 1/18th of an inch.

If you have additional questions about Laser Cataract Surgery, please do not ever hesitate to call our office at 713-626-5544 and speak to our experts.

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The doctors at Slade and Baker Vision have either authored or reviewed and approved this content.

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Houston, TX 77027

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