Is Laser Cataract Surgery Better Than Regular Cataract Surgery?

Cataract surgery is among the most commonly performed and safest surgeries in the world, with approximately 4,000 procedures carried out each day by the NHS alone. But that doesn’t mean that all cataract surgeries use the same method – nor does it mean that they are created equal.

Methods of cataract intervention have developed over many centuries – and continue to do so today. While the earliest cataract treatments resulted in poor outcomes and often the development of additional complications and even blindness, today, cataract surgery is largely a safe and effective procedure. In fact, surgery is the only effective treatment for cataracts.

Modern cataract surgery involves creating incisions in the surface of the eye through which the cataract can be broken up. This can be done using a blade (“regular” surgery) or a laser (laser surgery). In this article, we’ll be taking a look at some of the earlier approaches to cataract surgery and ultimately answering the question: Is laser cataract surgery better than “regular” cataract surgery?

The Development of Cataract Surgery

The earliest cataract surgery which still resembles the procedure carried out today was first performed in 1747 by French surgeon Jacques Daviel. Often credited with being the ‘Father of modern cataract extraction surgery’, Daviel used a corneal knife to create a small incision in the surface of the eye and use a blunted needle to puncture the lens capsule. This would allow him to extract the clouded lens using a spatula and curette.

Sounds pretty gory, right? Unfortunately, the procedure was associated with a high risk of complications and longer healing times than are seen today. Furthermore, with a success rate of around 50%, Daviel’s early iteration of cataract surgery was more effective than other primitive treatments that came before it.

Modern Cataract Surgery

Daviel’s procedure may have been less successful than modern cataract surgery, but it did lead to the development of increasingly effective iterations. Today, cataract surgery also involves eye-surface incisions, but the tools and technologies used are much more advanced.

There are essentially two ways to perform modern cataract surgery, though the basis of each procedure remains the same. Once the incisions have been made, giving the surgeon access to the cataract, an ultrasound probe is inserted to apply soundwaves that break up the clouded lens. The pieces are then suctioned out, making room for an artificial lens – called an intraocular lens – to replace the natural lens.

Traditional cataract surgery uses a blade to create incisions in the cornea. In contrast, Laser Cataract Surgery employs a high-precision laser. So, which of these two procedures is better – regular cataract surgery or laser cataract surgery?

Laser Cataract Surgery

Refractory laser technology can now be used for a wide range of refractive errors and conditions. While treatments such as LASIK, and ReLEx SMILE are used to address common errors such as myopia and hyperopia, precision lasers can also be useful in cataract surgery.

In Laser Cataract surgery, an ultrasound camera is used to precisely map the surface of the eye and collect measurements of the lens. This information can then be fed into the laser to determine the exact size, depth, and location of the incisions.

The laser may then be used to create the incision in the cornea and in the capsule in which the lens sits. Energy from the laser can also be used to soften the cataract before the ultrasound probe breaks it up.

Who is Suitable?

Suitability for laser-assisted cataract surgery can depend on a number of factors; however, some people may benefit more from this type of surgery. For example, laser cataract surgery may be offered if you have astigmatism or if you require a premium lens.

This and other factors will be determined by your surgeon during your consultation and screening process.

What are the Benefits?

The first thing to note when it comes to cataract surgery is the accepted safety and effectiveness of both regular and laser-assisted procedures. That being said, evidence suggests that laser cataract surgery tends to achieve slightly better results.

According to one study comparing the two surgeries, laser-assisted cataract surgery was slightly more likely to achieve target refractive outcomes. The use of mapping prior to surgery may also help the surgeon to avoid possible complications.

Nonetheless, both regular cataract surgery and laser cataract surgery are extremely safe and effective solutions to the development of cataracts.