Important articles that influence our care
Our thoughts on laser cataract surgery
Laser cataract surgery (FLACS, Femto cataract surgery), is an interest technology, that was introduced prior to us having a wide range of TORIC IOL lens implant options. It would seem to offer a theoretical advantage of being more precise. Lasers also have formed a positive bias in the publics mind because of their successful use in corneal refractive surgery (LASIK) which we have been using in Ophthalmology for over 25 years. However, it is important to remember that LASIK is using a laser to reshape the cornea to change its properties as a lens to focus light. There is no other way to do this besides using a laser. In cataract surgery light is primarily focused by the lens implant and not changes to the cornea. In FLACS the laser is a different type of laser, and is used to make corneal incisions and break apart a lens. Ophthalmologists have already been doing this for decades using vetted and modified surgical techniques for decades and spend years learning these techniques in their training. FLACS was introduced in the early 2010s. When FLACS was introduced, it was questionable how it improved quality, speed, and safety over modern cataract surgery techniques that ophthalmologists spend at least 4 years learning how to perform in surgical training residencies and fellowships. FLACS primary advantage was making more accurate LRI incisions over manual diamond blade incisions for astigmatism correction. However, soon we had many TORIC IOL lens options to choose from. FLACS lasers are expense to purchase and maintain for eye practices and these costs are passed on to patients. At this point we have 10 year studies that support that FLACS can be used safely for cataract surgery, but do not provide significant evidence that FLACS provide safer outcomes than the advanced manual surgical techniques that ophthalmologists spend years training to use. Also visual outcomes are primarily determined by the lens implant chosen and measurements taken before cataract surgery. Please see the below article links that detail long terms study results using lasers for cataract surgery.
Femtosecond Laser-Assisted Cataract Surgery A Report by the American Academy of Ophthalmology