Laser replaces blade in eye procedure

A year and a half after its FDA approval, laser cataract surgery is available to Bascom Palmer patients

09/04/2012 12:00 AM

09/03/2012 11:55 PM

Three years ago, Dr. William Culbertson of the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine went to the Dominican Republic to participate in a clinical trial in which a laser would be used to perform cataract surgery — previously done with a blade.

“The lasers have been [FDA] approved for LASIK surgery [in the U.S.] for about 10 years, but have only been approved in the U.S. for about a year and a half in terms of cataract surgery,” Culbertson said.

Laser cataract surgery is more precise, less traumatic and offers patients better outcomes, doctors say. In addition to removing the cataract, the doctors often can improve patients’ vision by correcting some of the same problems that LASIK addresses.

“Cataracts affect nearly 20.5 million Americans age 40 and older. By age 80, more than half of all Americans have cataracts,” according to the American Academy of Ophthalmology.

The first laser cataract surgery in the United States was performed in Houston in 2010.

As an ophthalmologist and cataract surgeon at Bascom Palmer, Culbertson has been performing cataract surgery for 32 years at the rate of about 15 surgeries a week. But soon, he won’t be doing them manually anymore.

“We just heard today that within two weeks we will be receiving the Optimedica laser,” Culbertson said last week. At the moment, he and one other doctor at Bascom Palmer are trained to do the procedure and they’ll start immediately, he said.

Dr. Paul Mann, medical director of the Mann Eye Institute in Houston, performed his first laser cataract surgery at his institute in February 2010 with an Optimedica Catalys laser.

“What the laser is really doing for me now is it’s giving me a very safe and reproducible opening so I have good access to the cataract in the capsule,” Mann said, “And then it’s softening the lens using less energy, and what that means is that the patient is going to have a less traumatic surgery and quicker visual recovery.”

At the moment, Mann said, doctors still have to use a blade to make two entryway incisions, which the laser could otherwise do, and that the laser could also be used to “alleviate astigmatism,” he said. Mann said he expects these practices to be FDA approved within a couple of months, he said.

But Pat Kane, 70, of Woodlands, Texas, didn’t wait for all four FDA approvals. As soon as Mann got the machine in his hands last February, Kane, director of nursing at the institute, was the first to volunteer for the procedure.

“We did my first eye at 8 a.m., with Dr. Mann and then my second eye at 1 p.m., with Mike Mann, his father,” she said. “I have the most incredible vision [now].”

Kane has been an eye nurse for 40 years. Since the procedure takes only about 10 minutes, eyedrops are used as local anesthesia, and the patient feels no pain, Kane said she was up and working between surgeries.

“After my second surgery at 1, my husband said, ‘Now that’s enough,’ and he drove me home,” she said.

Join the Discussion

Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Terms of Service