Laser Cataract Surgery in Houston, Texas
Laser cataract surgery is available in Houston at Slade & Baker Vision. We 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.
Laser Cataract Surgery: The Procedure
Laser Cataract Surgery is performed in a fully certified, dedicated eye surgery center. The procedure only takes fifteen to twenty minutes, although plan on two to three hours for the entire process on the surgery day. 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. 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).
Treating Your Astigmatism
You may have astigmatism and not even know it. Even people who have never worn glasses or contacts can have astigmatism in the cornea that only becomes visually apparent after the natural lens or cataract is removed. It can occur along with nearsightedness and farsightedness and, if present, will blur your vision at all distances.
There are two main types of astigmatism: corneal and lenticular. Corneal astigmatism is present when the cornea, or outer window of the eye, is more curved in one direction than the other, like the shape of a football. Small amounts of corneal astigmatism can be neutralized or minimized by the shape of the natural lens inside the eye, which is why some people have astigmatism and never knew it.
After cataract surgery with astigmatism treated (left) versus after cataract surgery with untreated astigmatism (right).
With lenticular astigmatism, the lens inside the eye can also be curved and can balance the corneal astigmatism. When the lens is removed, however, patients with corneal astigmatism will experience blurry vision that will require glasses unless they have their cornea treated for astigmatism during their cataract procedure.
At Slade & Baker Vision we use our femtosecond laser to treat small amounts of astigmatism at the time of surgery. For patients with more significant astigmatism we use one of the Advanced Toric IOLs that have built-in astigmatism correction. As with everything at Slade & Baker Vision, the surgical plan is totally customized.
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.
When should I get cataract surgery?
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 drive at night, read, see 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.
What is the difference between standard cataract surgery and the laser cataract surgery that you do?
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.
Will standard (ultrasonic) cataract surgery become obsolete in the near future?
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 the 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.
What is the difference between traditional cataract surgery and laser cataract surgery?
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.
Am I a candidate for laser cataract surgery?
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 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 white part of the eye, and its underlying structures. No one has the same fingerprint, or eyes!
Will I need to wear glasses or contacts after the surgery?
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 being glasses-free after surgery. In general, taking a vision correction approach to cataract surgery (which includes use of the laser and possibly an 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.
What should I expect on the day of surgery?
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!
Laser Cataract Surgery Reviews
“I can say the Laser Cataract Surgery at Slade & Baker was the easiest thing I have ever done. It was so comfortable. It was like going in, then you blinked, and you came right back out. It was so simple, it was unbelievable. I trusted Dr. Slade and his reputation so much that I never worried about being the first Laser Cataract Surgery patient.”
* Our first laser cataract patient and the first Laser Cataract Surgery patient in the United States.
“The Multifocal IOL was an out-of-pocket expense but I sew a lot and I just wanted to have the best vision I could possibly get. Knowing I had a better chance of being able to see close up without glasses was the main reason I chose Slade & Baker Vision. I can now drive, read and do my computer work without my granny glasses.”
* First Ophthalmologist in the U.S. to have laser cataract surgery on his own eyes.
“Before surgery, I had astigmatism and my night vision was the first thing to go. I was on the computer for about 8 hours a day and my nose was touching the glass to see it! The laser cataract procedure at Slade & Baker was so patient friendly. I’m amazed that I am not wearing glasses anymore. The colors are so brilliant now on my computer screen. The entire team was so professional, everything has been great.”