Alicia Nash of Miami was tired of wearing glasses. So she went to her doctor and, at age 57, discovered she had the beginning of cataracts.
Although they weren’t yet affecting her sight, she knew both her parents had had cataract surgery in their 70s. And her mother, who is now 85, underwent cataract surgery twice.
Working with Dr. Richard Kalski, who has his own South Miami practice and works with Fort Lauderdale Eye Associates, Nash was told that she had the option to lose the cataracts as well as her glasses.
“The amazing thing about being alive today is that technology lets us achieve things in cataract surgery we wouldn’t have even dreamed about five years ago,” says Dr. Andrew Shatz, medical director at the SightTrust Eye Institute in Sunrise.
Available for only about eight months, femtosecond laser to treat cataracts is not only changing the way the surgery is performed but also the results you can expect after your procedure. The laser is named for the femtosecond, an ultra-short period of time that measures the laser’s optical pulses of light, which are used to cut tissue.
A femtosecond laser was initially used for laser vision correction or Lasik. But that version wasn’t appropriate for cataract surgery.
“It seemed like a very good laser looking for something else to do,” says Dr. William Culbertson, professor of ophthalmology at the University of Miami’s Bascom Palmer Eye Institute.
About seven years ago, he teamed with a colleague in California to develop a laser that could be used for cataract surgery. Their prototype worked well cutting plastic tissue, so they gradually refined it.
Over time, they proved their laser could make very precise microscopic incisions in the capsule and cornea of the eye and soften even the hardest cataracts. They advanced to clinical trials, which led to FDA approval about 1½ years ago.
“This laser makes routine cataract surgery easier, difficult surgery routine and impossible cataract surgery possible,” says Culbertson, quoting a colleague who was involved in the clinical trials.
Depending on the individual, when laser surgery is teamed with premium multifocal lenses, the results can be much better vision. After all, the lenses allow you to see both far and relatively near from the same eye. And astigmatism can be corrected with the choice of either a lens or with laser cuts that reshape the eyeball.
“In the last few years, our focus has been not only to remove the cataract and get rid of the cloudy vision but to make your vision as clear as it can be without glasses, ” Culbertson says.
Cataracts develop when the protein in the lens of the eye becomes cloudy. This might be likened to a newspaper left in the driveway that turns yellow, explains Dr. Frank Spektor of the Center for Excellence in Eye Care in Miami. In the eye, this can be caused by things such as years of sun exposure, smoking, diabetes and obesity.
When our parents and grandparents were diagnosed with the beginnings of cataracts in middle age, their doctors were likely to watch those cataracts for another 10 to 15 years before treating them.
They didn’t want to rush patients into an operation that could have surgical complications. And they wanted to be sure the patient’s vision was affected enough by cataracts that they would see an improvement after the surgery, Shatz says.