Hi I'm Surendra Basti, I'm the director of the cataract service at the department of
ophthalmology Northwestern Medicine. Today we're going to perform femtosecond laser-assisted
cataract surgery and northwestern medicine was among the first academic departments in the nation
to adopt this exciting technology so today join me for this edition of inside OR.
today's procedure is expected to take us less than an hour the first part is done with the
femtosecond laser where the patient is very much awake but the eye is fully anesthetized and the
second part of surgery is done in the operating room and that's expected to take about 30 minutes
so the laser takes an image of the eye and then takes a cross-section of the eye and
the measurements permitted to program the laser so that it can accurately do the surgical steps
the laser just opened the cataract and it's now dividing the cataract into six pieces
and in just a moment it will create the incision in the eye
so the laser part's done what we're going to do is mark the eye before we go to the next room
your eye is anesthetized so you're not going to feel this i'm just going coming next to the eye
to make what we call reference marks so the rest of the surgery we do in the operating room
and we're ready to head there now so inside the eye all of us have a structure called the lens
and when the lens begins to get cloudy that's what we call cataract so cataracts commonly occur in
people in their 70s and 80s however genetics uv light cigarette smoke steroid medications
these are risk factors for cataract formation so the laser opened the cataract in a very circular
manner and i'm just moving the cataract around and that makes cataract removal a lot easier for us
so we have these ridges created by the laser here those ridges permit us to very easily
divide the cataract into six pieces sense of gentle suction and small amounts of ultrasound
we will suck out the cataract that's been broken by the laser the cataract's been completely
removed and what you can see here is even round opening which makes my placement of the lens very
precise so the callisto device is prompting us to place the lens in the direction of the blue line
i'm just going to make what we call as a reference mark that i can use when i actually place the lens
the lens is made of a material called acrylic and acrylic has been observed in the human eye
for over 70 years now so it's going to stay in the human eye for a human lifetime some
of us look at it as a legacy that we literally leave behind from what we do for the patient to
enjoy for the rest of their life the cataract has an outermost covering called the capsule
and the artificial lens is actually going back inside the capsule so essentially the lens is
going in the same location where the cataract was we're using this intraoperative guidance system
here to perfectly align the lens at the three dots indicating where the astigmatic correction is
is nicely aligning and overlapping with the blue line created by the callisto device
we're now going to check all the incisions make sure the eye is like we want it to
be with the tissues looking physiologic and also the incisions looking very strong after
the surgical procedure the eye feels a little scratchy and teary perhaps for a couple of days
the patients are able to begin to see improvement in vision within a day and details of objects
and high quality vision is restored in the first one to three weeks after the surgical procedure
so we expect the patient to make a good recovery she was nearsighted her whole adult life and i
expect starting tomorrow that will change permanently she'll have a very broad range
of vision even without eye glasses and hopefully that will serve her well for the rest of her life
thank you for joining me for this edition of inside the OR.