When surgery was finally performed, the doctor used a metal or diamond blade to open the eye, remove the cataract with ultrasound and suction, then implant a basic lens that let the patient see either near or far. Glasses were still necessary for either distance or close work.
This manual procedure remains a relatively safe and effective method for treating cataracts, especially when teamed with premium lenses.
But the advantage of laser is that the surgeon can customize each cut for the patient’s eye. Additionally, little or no ultrasound is required for removing the cataract and the procedure is less risky.
“With less energy going into the eye, you tend to get less swelling, so recovery is potentially quicker and our results are more precise and accurate,” Shatz says.
Also, real-time scans of the eye made during surgery allow the doctor to customize each cut.
There are about 200 of these $500,000 machines made by four companies in use throughout the United States. However, there are only about a half-dozen in South Florida and their capabilities differ, depending on the manufacturer and its FDA approvals.
Spektor, who does laser surgery at the Medical Arts Surgery Center at Baptist, likens the size of the laser machine to a Smart car sitting in the operating room. “It even has wheels,” he says.
But unlike a Smart car, laser surgery is relatively expensive. Early cataract surgery may be deemed cosmetic and that can mean it’s not covered by insurance, leading to an out-of-pocket expense of $4,000 to $7,000 per eye.
And even if insurance or Medicare covers some of the costs, it’s usually only for the manual surgery and a basic lens. “The government doesn’t care if we do the surgery with a stick or a laser, it will only pay one amount,” Spektor says.
The use of a laser and a premium lens may add $1,500 to $4,000 in out-of-pocket expenses for each eye.
But some patients don’t mind. Nash, the boomer whose cataracts were in the early stage, can now read a menu, work at her computer and look up a number in the phone book without glasses.
“I don’t need glasses for anything. It means a lot,” she says.