When it comes to cataract surgery, there is no such thing as a “one size fits all” approach. With Americans living longer nowadays, most of us will develop a cataract in our lifetime and will have to make a choice as to how and when we want to have the cataract removed.
Cataract surgery is now being offered to patients at a younger age so they can enjoy the benefits of clear vision. The major decision that patients face is what type of procedure they prefer: traditional cataract surgery or laser-assisted cataract surgery. According to YourSightMatters Medical Director Jeff Taylor, M.D., of The Eye Surgery Center of Paducah, in Kentucky, each method has its merits. Dr. Taylor performs both procedures and concludes, “I think both methods are safe and both are effective and when it comes down to it, it is patient preference in the end.”
You may be faced with this decision right now, and you may wonder how to choose the type of cataract surgery that is best for you. While it is understandable that you may feel overwhelmed, it is important to remember that both methods have the same outcome. The brittle, deteriorated eye lens (cataract) is removed and replaced with an artificial lens called an intraocular lens (IOL). The major difference between traditional cataract surgery and laser-assisted cataract surgery is how the procedure is performed.
Let’s look at some of the distinguishing factors between these two methods:
- Traditional cataract surgery uses a metal or diamond blade to perform the procedure, but laser-assisted cataract surgery is bladeless.
- Traditional cataract surgery uses phacoemulsification (ultrasound waves) to break up the deteriorated lens, but laser-assisted cataract surgery uses a femtosecond laser that emits short pulses.
- Laser-assisted cataract surgery allows your doctor to create a 3-D map of your eye called an OCT (optical coherence tomography) that provides precise coordinates for the laser to make incisions. Traditional cataract surgery utilizes the human hand to create the incision, remove the lens and insert the IOL.
- Traditional cataract surgery is often covered by insurance, but laser-assisted cataract surgery is usually not covered by insurance.
Timothy Ehlen, M.D., of Minneapolis Eye Center agrees that both procedures are safe and effective, but he points out that laser-assisted cataract surgery has some distinct benefits. With the OCT image, the laser can create an incision with a precise location, depth and length in all planes. Also, the accuracy of the incision is not based on the surgeon’s experience. “Possibly the best benefit is that laser-assisted cataract surgery can treat astigmatism, or an irregularly shaped cornea, where traditional cataract surgery cannot,” observes Dr. Ehlen.
While Dr. Ehlen’s expert opinion may convince you that a pre-programmed laser is the best option, let’s hear from another cataract specialist, David P. Rowell, M.D., of Salem Laser and Surgery Center in Salem, Oregon. Dr. Rowell says it is important to note that traditional cataract surgery is one of the most frequently performed surgeries in the United States, and many surgeons praise traditional cataract surgery because of the low risk of infection and predictable outcome. “Traditional cataract surgery has been used routinely for decades with great success, and many patients prefer a ‘tried and true’ approach,” says Dr. Rowell. “We can now perform some cataract surgeries with incisions of just a few millimeters, and often these incisions are self-sealing and do not require sutures.”
Traditional and laser-assisted cataract surgery are both effective methods to restore cataract-related vision loss. Most likely, it is just a matter of time until each of us needs to have a discussion with our ophthalmologist about what type of procedure would be best for our cataract removal. It certainly doesn’t hurt to start thinking about some questions to ask your ophthalmologist at your next comprehensive eye exam. Dr. Taylor sums up the laser vs. traditional debate perfectly by saying, “I reserve laser cataract surgery for patients with astigmatism or presbyopia to help reduce the need for glasses. When it is necessary, the laser offers the precision that the human hand cannot match. However, with small incision cataract surgery, incisions are so small that it is not necessary to use a laser in most cases.”
If you are seeking a qualified ophthalmologist for your eye care or an experienced surgeon who specializes in cataracts, please contact one of our YourSightMatters partners below, or use our Find a Physician locator tool to find a specialist in your area.