One time I saw an ad for “laser smoking cessation therapy.” That was the moment I knew “laser” had reached peak marketing-speak status. I’m still not sure how it was supposed to work. Maybe they used a label maker to print out “Anti-Smoking Laser” and put that on a laser pointer. Then they shined it on people? So many questions that I’ll never have answered because looking it up would ruin the fun.

Laser Is Not Just A Buzzword

I always think about that advertisement when I’m about to write about laser cataract surgery. I’m too deep in the field to know if the idea hits people the same way that the anti-smoking laser ad hit me. If so, this blog should help – because sometimes, “laser” is just a buzzword. This is not one of those times. For a lot of folks, laser cataract surgery is measurably, qualitatively better in many ways than standard cataract surgery. Let me explain why.

Cataract surgery has four main steps. Make a 1/10th of an inch passageway into the eye, create a round opening in the capsule surrounding the cataract, remove the cataract, and place a new lens in the eye. Computer-controlled laser lets us do the first three of those more perfectly and precisely than possible with human hands. There’s oftentimes an extra fifth step for folks with astigmatism who want to fix at the time of surgery. It may come as no surprise that a computer-controlled laser wins hands down in that contest as well.

The Importance Of A Skilled Surgeon

For the longest time, the precision of cataract surgery was based almost entirely on the skill of the surgeon. And that’s worked out great, because they’re very precise people! So why give a computer a job that a precise person can do? It would seem like it’d be better to have an experienced, thinking surgeon to handle the inevitable vicissitudes guaranteed by every unique case.

And that is true. But there are steps to the process that don’t require creative thought. Just like a skilled accountant can’t be replaced by a computer, but even still could never compete with a computer when it comes to crunching numbers. Some steps require exact repeatability – the same parameters being met the same way, every time. That is also true in surgery.

Take, for instance, the creation of the round opening in the capsule of the lens: the step of cataract surgery called the capsulotomy. The surgeon who’s done that 5000 times is generally going to be better at it than one who’s done it 50 times. “Better” in this case means more perfectly circular, more centered, and exactly the right diameter. It doesn’t mean being more creative or more reactive. And the best circle creating person on earth can’t match the perfect circle that a computer makes.

Another example would be that “bonus” step to fix astigmatism. From a previous blog, you might remember that astigmatism is caused by the cornea being too curved, too “tight” along one axis. We’ve been able to help that for ages with a step of cataract surgery called a limbal relaxing incision (LRI). An LRI basically cuts a few layers of the tension at the outer edge of the cornea along that axis to unsteepen it. And now feel free to skip to the end of the blog if you want to avoid learning the specific details of LRIs in the next paragraph.

Laser-Assisted Cataract Surgery

A 600 micrometer blade was used – still is in places without a laser. But corneas come in all different thicknesses. So you can imagine how 600 micrometers would be a much deeper cut for some than others. With laser-assisted cataract surgery, however, we can measure the exact depth of the cornea where that tension needs to be released. The laser can hit the exact percentage of depth that we need for that exact eye in that exact place. Like magic! And it makes fixing astigmatism much more scientific and much less reliant on luck. I, personally, don’t even bother to forward those spam “forward to 10 friends for good luck” emails anymore. I don’t need to.

And here is where I realize there are too many ways to detail the advantages of laser-assisted cataract surgery to cover in one blog of reasonable length. It’s a good problem to have – having too much good news to share for it to fit in one entry. If you want more details about it, come on in and see us! I get downright animated when talking about this with patients. Every now and then a technology comes along that makes a seismic difference for a huge number of people. And while that may not have been the case for laser smoking cessation therapy, it is most certainly the case with laser cataract surgery.