Laser cataract surgical treatment – likewise called Refractive Laser-Assisted Cataract Surgical Treatment (ReLACS)– is an advanced kind of cataract surgical treatment that makes use of femtosecond laser modern technology to bring a brand-new degree of accuracy and also precision to certain actions in cataract surgical treatment that generally have actually been carried out with hand-held surgical devices.
These actions consist of:
- The corneal cut
- The anterior capsulotomy
- Lens and cataract fragmentation
The added accuracy, precision and also reproducibility of each of these actions, when carried out with a
laser, possibly can decrease specific threats as well as enhance visual end results of cataract surgical procedure.
The corneal laceration
The initial step in cataract surgical procedure is making a cut in the cornea.
Optical coherence tomography assists the surgeon to plan the area and also deepness of cuts made throughout a laser-assisted cataract treatment. OCT scans offer high-resolution and also cross-sectional images to make the cataract surgical procedure as accurate as feasible.
In traditional cataract surgical treatment, the surgeon utilizes a hand-held tool with a metal or diamond blade to produce a cut in the location where the cornea meets the sclera. This cut enables the surgeon to get to the inside of the eye to separate and also get rid of the cataract, which is a clouding of the eye’s all-natural lens that lies right behind the pupil.
Next off, an intraocular lens (IOL) is placed and also implanted, to replace the cloudy natural lens. The corneal incision is made in a unique way so it will self-seal when surgical treatment is complete, without any requirement for stitches.
In laser cataract surgical procedure, the surgeon develops a specific surgical plan for the corneal incision with an innovative 3-D image of the eye called an OCT (Optical Comprehensibility Tomography).
The objective is to develop an incision with a certain location, deepness and also length in all planes, as well as with the OCT picture and also a femtosecond laser, it can be carried out precisely without the variability of surgeon experience.
This is essential not just for precision but likewise for enhancing the possibility that the incision will certainly be self-sealing at the end of the treatment, which minimizes the risk of infection.
The eye’s natural lens is surrounded by an extremely slim, clear capsule. In cataract surgical treatment, the front section of the capsule is eliminated in a step called an anterior capsulotomy.
This allow the surgeon to get direct accessibility to the cloudy lens (cataract).
It’s extremely important that the rest of the lens capsule that remains undamaged in the eye is not harmed throughout cataract surgical treatment, due to the fact that it must hold the synthetic lens
implant in place for the rest of the patient‘s life.
In conventional cataract surgical treatment, the surgeon creates an opening in the capsule with a tiny needle and after that uses that exact same needle or a forceps to tear the capsule in a circular style.
In laser cataract surgical treatment, the anterior capsulotomy (a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye) is executed with a femtosecond laser like the type used in LASIK vision correction surgical treatment. Research studies have actually revealed that capsulotomies performed with a laser have greater accuracy and also reproducibility, meaning they can be repeated with accuracy.
Research studies likewise have actually revealed that laser capsulotomies allow better centering of the intraocular lens, and also IOL positioning is a significant factor in establishing final visual end results and also cataract fragmentation.
After the capsulotomy, the surgeon now has accessibility to the cataract to remove it.
Lens and cataract fragmentation
In traditional cataract surgical treatment, the ultrasonic gadget that breaks up the cataract is put right into the cut. Throughout this phacoemulsification (breaking up of the eye’s natural lens into small
pieces) procedure, the ultrasound energy can result in heat build-up in the laceration, which often can burn the cut and also adversely impact the visual end result by really causing astigmatism.
A cut burn likewise has a greater possibility of leaking as well as in some cases calls for several stitches to close it.
The laser, on the other hand, softens the cataract as it breaks it up. By separating the cataract into smaller sized, softer pieces, much less energy needs to be required to get rid of the cataract, so there ought to be much less possibility of burning and also distorting the cut.
Laser cataract surgical treatment might likewise decrease the danger of capsule damage that can trigger vision issues after surgical treatment.
The lens capsule is as slim as a cellophane cover and it’s is essential that the section that is left inside the eye after cataract surgical treatment intact, so it can hold the IOL in the appropriate position for clear, undistorted vision.
The reduced phacoemulsification energy required in laser cataract surgery might likewise make the procedure much safer to the inner eye, which reduces the possibility of certain complications, such as a detached retina.
Astigmatism correction at the time of cataract surgical treatment
To reduce the requirement for prescription spectacles or reading glasses after cataract surgery it is important that little or no astigmatism exists after implantation of presbyopia-correcting multifocal IOLs as well as accommodating IOLs.
Astigmatism normally is triggered by the cornea being a lot more bent in one meridian than others. To put it simply, it’s designed rather like an American football (as opposed to a baseball).
To minimize astigmatism, tiny cuts can be placed in the perimeter of the even more bent meridian; as the cuts heal, this meridian flattens somewhat to provide the cornea a rounder, even more balanced shape.
This treatment is known as Limbal Relaxing Cuts (LRI) or Astigmatic Keratotomy (AK). Surgeons can carry out LRI or AK by hand with a diamond blade, and also it is rather effective in minimizing astigmatism.
Throughout refractive laser-assisted cataract surgical treatment, the OCT picture can be made use of to prepare laser LRI or AK cuts in a really accurate location, length and depth. This enhances precision of the astigmatism-reducing treatment and also the possibility of good vision without glasses after cataract surgical treatment.