Cataract surgery with a femtosecond laser is a new technology for the surgical treatment of cataracts. The femtosecond laser enables extremely precise incisions to be made when opening the lens capsule and fragmenting the lens and therefore has the potential to make cataract surgery even safer.
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Article overview
- What is cataract surgery?
- How does a femtosecond laser work?
- Preparation for the operation
- Procedure for cataract surgery with femtosecond laser
- Advantages of the femtosecond laser procedure
- Possible complications and risks
- Follow-up treatment after cataract surgery with femtosecond laser
- Conclusion
Cataract surgery with femtosecond laser - Further information
What is cataract surgery?
Cataract surgery is the most common invasive medical procedure in Germany, with around 700,000 operations performed each year. It is one of the most successful therapies in all of medicine:
Many patients not only see better after cataract surgery than before, but better than ever before. This is the case when doctors correct pre-existing short-sightedness or long-sightedness with an intraocular lens (IOL) at the same time as removing the lens. The introduction of the femtosecond laser has the potential to make cataract surgery even more precise and safer.
How does a femtosecond laser work?
The femtosecond laser works with ultra-short pulses of light. One femtosecond corresponds to 10-15 seconds. The high energy density creates thousands of tiny air bubbles of water and carbon dioxide in the tissue.
These separate the relevant tissue layer precisely without damaging the neighboring tissue. The precision of the cut is not in the millimeter range, but in the micrometer range.
Preparation for the operation
A number of preliminary examinations are necessary before cataract surgery.
First of all, the doctor must measure the eye precisely in order to be able to calculate the properties of the replacement lens accurately.
Unlike the body's own lens, the artificial lens is not elastic. Therefore, it cannot focus at different distances. The natural refractive power of the eye is therefore lost.
Different types of artificial lenses are therefore available:
- Monofocal lens:
The monofocal lens has a focused focal point on the distance. The patient can see clearly in the distance, but requires a visual aid for near vision.
- Multifocal lenses:
Multifocal lenses have two or more focal points. The patient does not need a visual aid. Multifocal lenses are more sensitive and more complex to manufacture. They are therefore also more expensive.
As a rule, patients cope better with a monofocal lens. So if you have no problem wearing glasses or contact lenses, you should opt for this type of artificial lens.
For the examination, the patient is given eye drops that dilate the pupils. You should not drive after the examination.
Procedure for cataract surgery with femtosecond laser
Cataract surgery with the new femtosecond laser technology is performed in two steps:
- Step with femtosecond laser
- Manual step by the surgeon
Using a fine instrument, the surgeon opens the natural shell of the lens that is to be preserved in a minimally invasive manner: the lens capsule. This provides support for the implanted intraocular lens (IOL).
The disintegration and aspiration of the lens (phacoemulsification) is currently performed using a small ultrasound probe. The surgeon must carefully dose the ultrasound energy so as not to damage the sensitive back surface of the cornea (endothelium).
With femtosecond laser technology, the doctor no longer has to open the lens capsule manually with a sharp instrument. The femtosecond laser pulses do this with pinpoint accuracy.
The femtosecond laser also breaks up the lens . By shattering the lens with the femtosecond laser, ultrasound only plays a supplementary role. The ultrasound energy, which potentially damages the cornea and other eye structures, is no longer necessary.
A study by the Bochum University Eye Clinic showed that the femtosecond laser requires only a fraction of the effective phaco time. The eye is exposed to much less ultrasound energy.
Advantages of the femtosecond laser procedure
The femtosecond laser procedure is more precise and gentler and shows better results in terms of wound healing and visual improvement.
The precise round incision openings on the lens capsule allow the artificial lens to be positioned exactly, resulting in stable vision.
The femtosecond laser generates less heat, which normally damages the surrounding tissue.
Another advantage of the technology is that patients with astigmatism only need a single session to treat the corneal geometry.
The steps of cataract surgery @ bilderzwerg /AdobeStock
Possible complications and risks
According to current knowledge, there are no particular risks associated with the femtosecond laser. However, the capsule may become cloudy after the operation.
The so-called after-cataract (capsular fibrosis) can be treated quickly, once and painlessly with the special YAG laser. It no longer emerges afterwards
Follow-up treatment after cataract surgery with femtosecond laser
In the first days to weeks after cataract surgery with femtosecond laser, you will need to take eye drops to prevent inflammation.
With the standard IOL (monofocal artificial lens), you will need a separate visual aid. Your ophthalmologist will therefore check after a few weeks how strong your future glasses need to be.
Conclusion
The extremely precise incision guidance of the femtosecond laser and the high predictability are ideal for implanting a premium IOL, which ensures both optimum visual acuity at a distance and good reading ability at close range.