hello this is Dr Audrey Tai lasik and cataract surgeon ophthalmologist and cornea specialist
welcome to my channel Eye channel by eye surgeon today i would like to answer a
question that i often get from my patients before their cataract surgery what is the
difference between laser-assisted cataract surgery versus conventional cataract surgery
and we'll also discuss how does fentosecond laser work and how does it assist in each surgical step
during cataract surgery now you or your family member may have been diagnosed with cataracts
and recommended to have cataract surgery and the surgeon offered you options of having either
laser-assisted cataract surgery or conventional cataract surgery which one should you choose
to answer that question first let's talk about how does fentanyl second laser work
during laser system cataract surgery the type of laser we use is called a femtosecond laser it is
called a femtosecond laser it's because each laser pulse only lasts a few hundred femtoseconds each
femtosecond equals to 10 to the minus 15th of a second the femtosecond laser can fire thousands of
laser pulses each second to separate the tissue smoothly and continuously to create incisions
and both the location and the pattern of incisions are programmed by the surgeon using
an image guided laser system and it is highly customizable my patients often also ask me dr tai
if i choose to have laser system cataract surgery is it painful can i feel the laser pulses
fortunately the answer is no the phantom second laser portion of the cataract surgery only lasts
just a few minutes and during this portion of the surgery the eye is anesthetized with eye drops
so you won't be able to feel the laser pulses but you may be able to see different colors of lights
it's almost like a light show that being said let's talk about how femtosecond laser assists
each surgical step cataract surgery has four major surgical steps corneal incision capsulorhexis
cataract fragmentation and removal intraocular lens insertion corneal incision is the first
surgical step when the surgeon gains access into the eye through incisions on the cornea
during conventional cataract surgery the surgeon uses a very small blade usually between
two to three millimeters in width to create incisions during lasers is the cataract surgery
the incision sites are programmed by the surgeon using an image guided
laser system and then the femtosecond laser creates the incisions in just a few seconds
not only the location and the size of the corneal incision are highly customizable the
femtosecond laser can also create arc-shaped incisions on the cornea to treat astigmatism
and to improve uncorrected vision after surgery the next surgical step is capsulorhexis
capsulorhexis is the most crucial surgical step during cataract surgery the capsule is a very thin
tissue with an average thickness of seven microns and it wraps around the cataract
capsulorhexis is the step where circular opening is made on the capsule
and the surgeon has to gain access to the cataract through the circular opening of capsulorhexis
both the shape as well as the position of capsulorhexis can affect
where the intraocular lens sits in the eye and can affect vision after cataract surgery
therefore it is very important to create capsulorexis that's perfectly centered and as
circular as possible during conventional cataract surgery the surgeon creates the capsulorhexis
with a very fine instrument manually during laser assisted cataract surgery the position
and the size of capsulorhexis are programmed by the surgeon using an image guided laser
system and the femtosecond laser creates the capsulorhexis in a second you can see as a surgeon
i can customize both the position and the size of capsulorhexis where i exactly i want it to be
in my experience i found that the saturation of
intraocular lens is often improved with femtosecond laser capsulorhexis
the next surgical step is cataract fragmentation and removal this is the step
the cataract is fragmented and removed from the eye
during conventional cataract surgery the surgeon uses a very small instrument called chopper to
disassemble the cataract and remove the cataract from the eye by using phaco emulsification phaco
emulsification means using ultrasound energy to break down the cataract and remove it from the eye
during laser system cataract surgery the cataract is fragmented into different sizes
and shapes of smaller fragments by laser designed by the surgeon based on the surgeon's preferences
during this step it is very important to minimize the amount of time as well as ultrasound energy
used during phaco as increased vehicle time and ultrasound energy used during cataract surgery
are related to increased tissue damage occur during surgery
the more tissue damage occurred during surgery can result in increased recovery time after surgery
for vision the next surgical step is intraocular lens insertion during this step both during
conventional cataract surgery as well as laser assisted cataract surgery the surgeon inserts the
intraocular lens into the capsular bag through the capsular opening made during capsular rexes
both the position as well as the centration of the intraocular lens can affect vision after
cataract surgery if the intraocular lens sits just half a millimeter too forward or backward in the
capsular bag it can result in big differences in glass's prescription after cataract surgery
as i mentioned before both the position and the shape of the capsulorhexis can affect the
position of intraocular lens now we have discussed the differences between laser-assisted cataract
surgery versus conventional cataract surgery and how femtosecond laser assists each surgical step
i hope this video helps you understand those differences and you're more prepared
when having a conversation with your eye surgeon about your surgical plan
as always please remember cataract surgery has risks just like other types of surgery please
discuss with your eye surgeon about any specific questions that you may have about your vision
and your eye surgery if you learn anything new from this video please consider give this video
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thank you again for watching and i look forward to seeing you in my next video