Laser-Assisted Cataract Surgery

Customized, laser-assisted cataract surgery helps patients get through surgery with less pain, recover faster and see more clearly the same day, says ophthalmologist Dr. Mark Iacobucci of Tidewater Eye Centers.

A cataract is a condition when the proteins in the eye clump together, causing the normally clear lens of the eye to become cloudy. Cataracts usually form in the eyes of people 50 to 80 years old. People with cataracts often have impaired night vision. The surgery to remove the cloudy lens and replace it with a new clear lens is one of the safest and most commonly performed procedures in the United States.

Iacobucci has performed about 3,000 cataract surgeries. He began performing the LenSx procedure, using a special bladeless laser, about 18 months ago. Although LenSx is fairly new, the first part of the procedure is similar to Lasik surgery, says Iacobucci, who has performed about 1,000 Lasik surgeries.

Although not every cataract patient is a candidate for LenSx, for those that are, the surgery offers a number of advantages, says Iacobucci of Tidewater Eye Centers, with offices in Chesapeake, Portsmouth and Virginia Beach.

LenSx is precise,” he says. “The wounds are typically self-sealing.”

With the LenSx procedure, the surgeon can mark the cornea before surgery so that the new lens can be very accurately positioned. Then, using the computer-controlled laser, the ophthalmologist is able to quickly and accurately make a perfectly round, centered incision to remove the cataract, Iacobucci says.

“When I do cataract surgery the conventional way, I can make the opening close to perfectly round and centered,” he says. “But sometimes the tissue will tear different amounts. It’s hard to make the opening as accurately as the laser in every case.”

Speed is another advantage. Using standard techniques, creating the incisions and dividing the cataract into quadrants takes more than three minutes, he says. With the laser, it takes about 28 seconds. Less time in surgery equals less swelling, less pain and better vision for patients immediately after surgery, he says. Removing the cataract and placing the new lens takes the same amount of time either way, another five to 10 minutes.

LenSx offers better vision post-surgery to the 20 percent of patients with low to moderate astigmatism, he says. The surgeon can make a partial incision during surgery for placement of the new lens. When the patient sees the surgeon for follow-up several days after surgery, the doctor can numb the eye and adjust the astigmatism incision if needed for even more accurate vision, he says.

LenSx also allows for accurate placement of multi-focal lenses. With a multi-focal lens, most patients can see at all distances without glasses. Insurance covers the standard lens; getting a multi-focal lens instead requires patients to pay an additional $2,400 out of pocket.

Patients who have LenSx surgery also report less pain, Iacobucci says.

In fact, Iacobucci recently saw a patient who had had conventional surgery on his one eye and LenSx on the other eye. The patient reported that the LenSx eye had less pain after surgery and better vision on the first day than the eye on which he had conventional cataract surgery. The patient had a growth in one eye that prevented him from being a candidate for LenSx surgery in that eye.

Patients typically pay an additional $1,000 out of pocket for LenSx, which usually isn’t covered by Medicare or other insurance.

For some patients, the cost is worth it.

“Many patients are willing to pay $3,400 out of pocket to use the best technology and be glasses free after cataract surgery,” Iacobucci says.

Next: Here are 5 ways to improve eyesight without glasses or contact lenses.

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