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 better vision (without the help of glasses/contacts) after modern cataract surgery with Dr. Slade or Dr. Walton 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 or Dr. Walton 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 or Dr. Walton 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).

Feel free to call us if you have any other questions that we have not answered at 713-626-5544!