A new laser system for cataract surgery, with accuracy to a few hundred-thousandths of an inch, allows eye surgeons to optimize and customize the incision and ensure the best possible outcome.
The University of Illinois Hospital & Health Sciences System is the first academic medical center in the Midwest to offer the LenSx femtosecond laser to selected cataract patients.
The LenSx system provides a live, real-time image of the eye that allows the surgeon to set the laser to the exact required depth and dimension for the bladeless incision -- "to the micron," says Dr. Jose de la Cruz, professor of ophthalmology and visual science at the UIC College of Medicine and assistant director of the Millennium Park Eye Center, UI Ophthalmology's downtown satellite clinic.
Femtosecond laser technology uses an extremely short burst of energy to make a bladeless incision. Femtosecond lasers have been used in refractive surgery to create a thin flap in the lens. Recently, they have been approved by the FDA for cataract surgery, in which they are used to fragment the clouded lens for removal. A femtosecond is one-quadrillionth of a second.
The accuracy of the laser means the surgeon can be very confident of the centering of the new lens, which is critical in cataract surgery, de la Cruz said -- and especially so for the new multi-focal intraocular lenses, which work like bifocals and eliminate the need for reading glasses.
"I can see exactly where I want to place my incisions, as well as the exact diameter and depth of the cataract, prior to cataract fragmentation," de la Cruz said. "Once the laser is set in position, I press the pedal, and the laser will divide the cataract into pieces in less than 20 seconds." The patient is then moved to an adjoining operating room, where de la Cruz removes the cataract and replaces it with an intraocular lens. The whole procedure can be done under topical anesthesia.
After surgery, there is a "very quick visual recovery," de la Cruz said. Most patients wear a clear eye patch for a day and are seeing well almost immediately. Follow-up appointments are scheduled for the first and third weeks following surgery.
The LenSx laser has been in use at UI Hospital since February.
"Most of our cataract surgeons have already trained on the machine and are offering it to their patients," de la Cruz said. "As an academic medical center, we are also incorporating this cutting-edge technology in the training of our ophthalmology residents and fellows."