Laser Assisted Cataract Surgery


What is laser-assisted cataract surgery?

In laser-assisted cataract surgery with Dr. Stefano, a femtosecond laser is used to make the corneal incision and to remove the anterior capsule of the lens. The laser then is used again to make a series of cuts in the cataract-clouded lens. Then the ultrasound probe is inserted, as with traditional cataract surgery, to finish breaking up and suctioning out the clouded natural lens prior to placing the new, crystal-clear intraocular lens.

By adding the femtosecond laser to the procedure, we can bypass the need to use a surgical blade. This adds a whole level of precision to this procedure.


How is laser-assisted cataract surgery different from traditional cataract surgery?

For cataract surgery, Dr. Stefano uses our femtosecond laser in three areas. After the laser software creates a 3D image of your eye, the incision location is mapped. Then he uses the femtosecond laser to create the incision in the cornea, removing the anterior capsule of the lens. This provides access to the cataract-clouded lens. For its second job, the laser is used to make a series of cuts in the cataract-clouded lens. This laser scoring of the lens reduces the amount of ultrasound energy needed to break up the lens before suctioning it out. The third possible use of the laser is if you have astigmatism: the laser can create the peripheral corneal incisions that reduce astigmatism. By using the laser for the entry incision, scoring the cataract, and making peripheral incisions, Dr. Stefano never needs to use a surgical blade.


What are the advantages of laser-assisted cataract surgery?

At Shenandoah, Dr. Stefano believes in staying at the forefront of eye surgery technology and the femtosecond laser is a jump forward. Here are some advantages and benefits for our patients to using this laser for cataract surgery:

  •     The computer guidance provides greater surgical precision.
  •     All incisions can be made with the laser. This removes the use of any surgical blades.
  •     Laser scoring of the clouded lens before removal reduces the amount of ultrasound energy needed to break up the lens.
  •     When opening the capsule, the laser creates far less potential for tearing the capsule than when using forceps.
  •     When breaking up the cataract, the laser creates less heat, which lowers the risk of damaging the incision.

Who is a good candidate for laser-assisted cataract surgery?

If you’re suffering from the increasing cloudiness that’s due to the development of a cataract in one or both of your eyes, the odds are you’re a great candidate for laser-assisted cataract surgery at Shenandoah LASIK & Cataract Center. As mentioned above, there isn’t a cure for a cataract-clouded lens other than removing it and replacing it with an artificial intraocular lens.

If you have these symptoms of cataracts, this is a great procedure to return crystal clear vision: 

  •     Decreased color vibrancy
  •     Blurred vision
  •     Poor night vision
  •     Increased glare
  •     Halos surrounding lights
  •     Double vision
  •     Frequently changing eyeglass prescription
  •     A feeling there is a film over the eye

These procedures are remarkably successful, and there are few limits on patients being able to have the benefit of adding a femtosecond laser to these procedures. Dr. Stefano will discuss any possible issues with you during your consultation.


Is preparation for laser cataract surgery different from traditional cataract surgery?

No. Preparation, such as testing your eyes and selecting which intraocular lens you want to replace the cataract with are the same in both procedures. Otherwise, preparations are quite minimal.


How is laser cataract surgery performed?

Once a cataract has developed in the lens of an eye, the only treatment is surgery to remove the lens and replace it with an artificial lens. If left untreated, the cataract will continue to progress, eventually leading to blindness in the eye. But there is no reason to wait, as cataract surgery is one of the safest, most effective surgeries in the world. In the U.S., the success rate with this surgery is over 98 percent.

At Shenandoah, we use minimally invasive, small-incision, no-stitch cataract surgery known as phacoemulsification (phaco) surgery. We add the femtosecond laser for greater precision and accuracy. By using this FDA-approved laser option, we can bypass the need to use a surgical blade. The surgery is remarkably fast, requiring only five to 10 minutes. Here’s how we do it.

The femtosecond laser system first creates a 3D image of your eye for guidance. This allows Dr. Stefano incredible accuracy when mapping the incision location. 

Next, the femtosecond laser creates the corneal incision and removes the anterior capsule of the lens. This gains access to the cataract-clouded lens. The incision is very small. Now the laser makes a series of cuts in the cataract-clouded lens. A probe is then inserted, and it delivers ultrasound energy that breaks up the cloudy lens. At the same time, the probe uses suction to gently remove the small lens pieces. The earlier scoring of the lens reduces the amount of ultrasound energy needed to break up the cataract lens. If you have astigmatism, Dr. Stefano may use the laser at this point to create peripheral corneal incisions. These reduce the condition. Otherwise, new intraocular lens (IOL) choices also can correct for astigmatism. 

The final step of the surgery is to insert the artificial intraocular lens. Today’s advanced IOLs are foldable and are inserted through the same small incision through which the original lens was removed. The small incision size doesn’t require any sutures; it will heal on its own.


What is recovery like after laser-assisted cataract surgery?

Recovery for laser-assisted cataract surgery at Shenandoah LASIK & Cataract Center is the same as traditional blade surgery.

After your brief surgery, we’ll place an eye patch on your treated eye. We provide you with a protective shield to wear when sleeping for the next several days. Your vision will be blurry at first, but this rapidly improves in just a day or two. Your eye may itch somewhat, but you cannot touch the area at all. You also need to be cognizant of avoiding actions that increase blood pressure to your face. Things such as heavy lifting, bending over, and other actions that move blood to your face are out. We provide you with eye drops that prevent inflammation and infection. They also control the pressure inside your eye when healing. 

Full healing can take up to two months, but you can return to normal activity in just a few days. You may or may not require glasses for some tasks after your surgery. This depends on the replacement intraocular lens you selected. If your other eye also has a cataract, we usually schedule the second surgery one to two months after the first.


Will I need glasses after having laser-assisted cataract surgery?

Up until around the turn of the new century, patients having this surgery had only one option for a replacement intraocular lens, monofocal IOLs. As their name implies, monofocal lenses correct for one focal length of vision, either distance or up close. Patients would choose which option they wanted, usually choosing distance, and they would wear glasses for the other distance, usually for up close vision such as reading. 

That has changed with today’s technologically advanced IOLs. Now there are various options for multifocal IOLs that provide excellent vision at all distances. These new IOLs are amazing; they can even correct for astigmatism and presbyopia (the condition that is almost universal after the age of 40 where our eyes have trouble with up close vision). You can read about the premium IOL options at Shenandoah here. If you choose to have your cataract replaced with one of these choices, you may not need eyeglasses for any distance again.


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“I have always been treated professionally and with kindness since my lasik surgery in 2000. I would and have recommended this practice to others.” – Yvonne

Dr. John A. Stefano has extensive experience in the laser-assisted cataract surgery, and can offer patients the latest, most advanced treatments to help preserve your vision and your overall quality of life. To learn more about our services, call (540) 722-6200 to schedule an appointment in our Winchester, VA office.

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