Today I would like to answer a question that I often get from my patients before their cataract surgery. What is the Difference between laser-assisted cataract surgery conventional cataract surgery? and we will also discuss that how does femtosecond laser works and how does it assist in each surgical step during cataract surgery.
Now you and your family members may have been diagnosed with cataracts and recommended to have cataract surgery and the surgeon offered you options of having either laser-assisted cataract surgery or conventional cataract surgery which one should you choose? To answer that question first let’s talk about How Does Fentanyl Second Laser Work?

Difference Between Laser Cataract Surgery and Conventional Cataract Surgery

During laser system cataract surgery the type of laser we use is called a femtosecond laser. It is called a femtosecond laser it’s because each laser pulse only lasts a few hundred femtoseconds.
each femtosecond equals 10 to the minus 15th of a second, the femtosecond laser can fire thousands of laser pulses each second to separate the tissue smoothly and continuously to create incisions, and both the location and the pattern of incisions are programmed by the surgeon using an image-guided laser system and it is highly customizable my patients often also ask me dr. Ruman if I choose to have laser system cataract surgery is it painful? Can I feel the laser pulses?
fortunately, the answer is no. The phantom second laser portion of the cataract surgery only lasts just a few minutes and during this portion of the surgery.
The eye is anesthetized with eye drops so you won’t be able to feel the laser pulses but you may be able to see different colors of lights. It’s almost like a light show that being said let’s talk about how femtosecond laser assists each surgical step. Cataract surgery has four major surgical steps;
  1. Corneal incision
  2. Capsulorhexis
  3. Cataract Fragmentation and Removal
  4. Intraocular lens insertion

1. Corneal Incision

The corneal incision is the first surgical step when the surgeon gains access into the eye through incisions on the cornea. During conventional cataract surgery, the surgeon uses a very small blades usually between two to three millimeters in width to create incisions during laser is the cataract surgery.
The incisions size is programmed by the surgeon using an image-guided laser system and then the femtosecond laser creates the incisions in just a few seconds. Not only the location and the size of the corneal incision are highly customizable. The femtosecond laser can also create arc-shaped incisions on the cornea to treat astigmatism and to improve uncorrected vision after surgery.

2. Capsulorhexis

the next surgical step is capsulorhexis and it is the most crucial surgical step during cataract surgery. The capsule is a very thin tissue with an average thickness of seven microns and it wraps around the cataract.
Capsulorhexis is the step where the circular opening is made on the capsule and the surgeon has to gain access to the cataract through the circular opening of capsulorhexis. Both the shape as well as the position of capsulorhexis can affect where the intraocular lens sits in the eye and can affect vision after cataract surgery.
Therefore it is very important to create capsulorhexis that’s perfectly centered and as circular as possible during conventional cataract surgery. The surgeon creates the capsulorhexis with a very fine instrument manually during laser-assisted cataract surgery.
The position and the size of capsulorhexis are programmed by the surgeon using an image-guided laser system and the femtosecond laser creates the capsulorhexis in a second that you can see as a surgeon.
I can see both the position and the size capsulorhexis where exactly I want it to be in my experience. I found that the saturation of the intraocular lens is often improved with femtosecond laser capsulorhexis.

3. Cataract Fragmentation and Removal

The next surgical step is cataract fragmentation and removal. This is the step the cataract is fragmented and removed from the eye. During conventional cataract surgery, the surgeons use a very small instrument called a chopper to disassemble the cataract and remove the cataract from the eye by using phacoemulsification.
Phacoemulsification means using ultrasound energy to break down the cataract and remove it from the eye.
Durin laser system cataract surgery the cataract is fragmented into different sizes and shapes of smaller fragments by laser designed by the surgeon based on the surgeon’s preferences.
During this step, it is very important to minimize the amount of time, as well as ultrasound energy used during phaco as increased vehicle time and ultrasound energy used during cataract surgery, are related to increased tissue damage that occurs during surgery.
More tissue damage occurred during surgery can result in increased recovery time after surgery for vision.

4. Intraocular Lens Insertion

The next surgical step is the intraocular lens insertion. During this step both conventional cataract surgery as well as laser-assisted cataract surgery, the surgeon inserts the intraocular lens into the capsular bag through the capsular opening made during capsular rexes. Both the position as well as the centration of the intraocular lens can affect vision after cataract surgery.
If the intraocular lens sits just half a millimeter too forward or backward in the capsular bag. It can result in big differences in glass prescription after cataract surgery.
As I mentioned before both the position and the shape of the capsulorhexis can affect the position of the intraocular lens. Now we have discussed the differences between laser-assisted cataract surgery versus conventional cataract surgery and how femtosecond laser assists each surgical step.
I hope this article helps you to understand those differences and you are more prepared when having a conversation with your eye surgeon about your surgical plan.
As always please remember cataract surgery has risks just like other types of surgery. Please discuss with your eye surgeon about any specific questions that you may have about your vision and your eye surgery.
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Categories: eyes surgery

Ruman Amjad

Hello, I am Dr. Ruman Amjad, an Ophthalmologist specializing in the field of eye care, particularly focused on helping individuals with swollen eyelids. I am thrilled to welcome you to, a comprehensive resource dedicated to providing accurate and reliable information on eyelid inflammation.


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