As a surgeon who has been performing cataract surgery, corneal transplants, and LASIK for 17 years, I have witnessed the amazing advancements in surgical techniques, equipment, and technology. And yet, the improvement in technology by itself means very little. The real question for me has always been: Will my patients see better, have less discomfort, and recover faster after surgery compared to an older technology? That is where it really counts.
For the past few years, I have been utilizing a new technology known as laser-assisted cataract surgery for a large number of my patients, and I was finally ready to answer my question: Did my patients who chose to have laser-assisted cataract surgery compared to standard cataract surgery have better outcomes? The answer, at least in my experience, is a resounding YES.
To illustrate the point, I would like to share the story of one of my patients. Let’s call her Jane (name altered to protect patient confidentiality). Jane is an amazing 80-year-old lady with a great sense of humor and a very active lifestyle. Over time, she noticed that she needed more light to read, and she couldn’t see the road signs as well when driving. An overall decline in her vision was progressively getting worse.
She was living by herself and was quite independent. The thought of having to give up reading or driving worried her. She had seen an ophthalmologist a couple of years ago who had diagnosed her with cataracts and recommended waiting for her cataracts to get worse prior to surgery. She had done a lot of research about cataract surgery and was nervous about the prospect of surgery. Specifically, she was concerned about the surgical blade making an incision in her eye. As a result, she had postponed cataract surgery as long as she could. What finally prompted her to come see me, in my office at Eye Care of East bay, was that she almost failed her DMV vision test.
After a complete examination, I agreed that she would benefit from cataract surgery. We had a thorough discussion about the new techniques of cataract surgery. I informed her that cataract surgery was one of the most successful eye procedures performed. We discussed the various ways of doing the surgery, including numbing the eye with eye drops as opposed to giving a shot behind the eye (she really liked that one), as well as using a laser to make the incisions in the eye and to break the cataract into smaller pieces that could be easily removed. We also reviewed her insurance coverage for the procedure, as it did not cover the laser portion. After talking all of this over with her very supportive family, she decided to schedule the surgery with the laser.
On the day of the surgery, I met her in the pre-operative area. She was a little nervous. The anesthesiologist and I had a chat with her and answered all her questions. The nurse then put an IV in her arm and we gave her some relaxing medicine while drops were put on her eye to dilate the pupil and numb the eye.
The laser procedure was done first and it took about 3 minutes. The laser made perfect incisions and broke the cataract into several small pieces. The cataract was removed in the operating room and took about 15 minutes. I put a clear shield on her eye and she went home about 30 minutes later with instructions about her post-surgical eye drops.
The next day, she was one of my first patients in the morning. I asked her about her night and she said she had some scratchiness in her eye and a little headache right after surgery that had subsided pretty quickly. She was already noticing a big improvement in her vision, and especially noticed that the colors looked much more vivid in the eye that had just had the surgery compared to her other eye. When I examined her eye, her cornea was nice and clear with minimal swelling and no redness. Once we had finished the exam and reviewed her eye drops, I asked her if she had any questions. Without hesitation, she asked: “When can I have my other eye done?”
Seeing my patients with great outcomes makes my day. I realize how fortunate I am to be in a position to help them achieve better vision. It is also an amazing time to perform cataract surgery and practice ophthalmology. We in our profession have a great opportunity to offer our patients the latest technologies, including laser-assisted cataract surgery, intraocular lenses that can decrease dependence on glasses (or contact lenses), and faster recovery times with amazing outcomes. That, in a nutshell, is why I love seeing my patients after laser cataract surgery.