Choosing Between Femtosecond Laser and Traditional Phacoemulsification Surgery

Choosing Between Femtosecond Laser and Traditional Ultrasound Phacoemulsification Surgery

Hello Dr.
Jiang, my right eye has a macular hole that was closed after undergoing vitrectomy.
Recently, I had cataract surgery to replace the artificial lens, which was performed using femtosecond laser-assisted surgery.
The day after the surgery, my vision was only 0.1.
Although there was no bleeding or pain, my vision has become significantly distorted compared to before the surgery.
An OCT examination showed that the macular hole is normal and there is no edema.
My vision is gradually recovering, but the distortion still persists.
I remember that during the surgery, after the laser procedure, I was transferred to the phacoemulsification table, and the entire process seemed quite complex and time-consuming.
I also recall that it took a long time to complete the phacoemulsification.
There is a claim online that during femtosecond laser surgery, pressure is applied to stabilize the eyeball for the laser treatment, which may not be beneficial for elderly patients or those with pre-existing eye conditions, and could even be harmful.
It seems that the procedure is not as flawless as advertised.
I am planning to have surgery on my other eye soon and would like to use traditional phacoemulsification.
Could you please provide some advice for this anxious patient?

Mao Mao, 60~69 year old female. Ask Date: 2015/12/29

Dr. Wang Zhishun reply Ophthalmology

Hello, we still recommend simple ultrasound phacoemulsification surgery.
Please consider this.

Reply Date: 2015/12/29

More Info

When considering the choice between femtosecond laser surgery and traditional phacoemulsification for cataract surgery, it is essential to weigh the benefits and potential drawbacks of each method, especially in the context of your specific eye health history, including the previous vitreous detachment and macular hole repair.

Femtosecond laser-assisted cataract surgery (FLACS) is a relatively newer technique that utilizes laser technology to perform several steps of the cataract surgery, including creating the corneal incision, breaking up the cataract, and sometimes even performing the capsulotomy (the opening of the lens capsule). The advantages of FLACS include increased precision, potentially less energy required to break up the cataract, and the ability to create more consistent and reproducible incisions. However, as you have experienced, there can be complications or unexpected outcomes, such as visual distortion or prolonged recovery times.

On the other hand, traditional phacoemulsification surgery, which uses ultrasound to break up the cataract, has been the standard for many years and has a well-established track record of safety and effectiveness. This method may be less complex in terms of the surgical process, as it does not involve the additional steps of laser treatment. For many patients, especially those with prior eye conditions or surgeries, traditional phacoemulsification may present fewer risks and a more predictable recovery.

Your concern about the pressure applied to the eye during femtosecond laser surgery is valid. The procedure does require stabilization of the eye, which can be uncomfortable, particularly for older patients or those with pre-existing eye conditions. This stabilization can potentially lead to complications if the eye is sensitive or if there are underlying issues that could be exacerbated by the pressure.

Given your experience with the first eye surgery, where you noted significant visual distortion post-operation, it is reasonable to consider opting for traditional phacoemulsification for your second eye. This choice may provide a more straightforward surgical experience and potentially reduce the risk of complications associated with the more complex femtosecond laser procedure.

In summary, while femtosecond laser surgery offers advanced technology and precision, it may not be the best option for every patient, particularly those with complex eye histories. Traditional phacoemulsification remains a reliable and effective choice for cataract surgery, especially for patients who have experienced complications with previous surgeries. It is crucial to have an open discussion with your ophthalmologist about your specific concerns, surgical history, and the potential outcomes of each procedure to make an informed decision that aligns with your visual needs and overall eye health.

Similar Q&A

Comparing Femtosecond Laser and Phacoemulsification for Cataract Surgery

Hello Doctor: I have an issue with macular folds in my eyes and am planning to undergo cataract surgery soon. I am eligible for both phacoemulsification and femtosecond laser surgery, but I am unsure if femtosecond laser is better for protecting the already compromised macula com...

Dr. Gao Pilin reply Ophthalmology
Hello: Femtosecond laser surgery offers more precise surgical control, which may be more beneficial for protecting the tissues surrounding the macula. It utilizes laser energy to fragment cataracts, reducing the impact on ocular tissues. However, for patients with pre-existing ma...

Understanding the Differences Between Old and New Laser Eye Surgery

I am considering laser eye surgery because there is a significant difference in prescription between my two eyes, approximately over 200 degrees. I usually experience dizziness when wearing glasses, so I only wear them when I need to see far away, which has led to a deterioration...

Dr. Hu Yusheng reply Ophthalmology
Hello, Miss Han: You mentioned that due to your thinner cornea, the recommended surgical method by your physician is PRK (Photorefractive Keratectomy). It is best to discuss the associated risks of the surgery with your surgeon, as each individual's physiology is different. ...

Comparing INTRALASE and B&L Technolas for Laser Eye Surgery

Hello, doctor. Could you please tell me which is better, the INTRALASE femtosecond laser or the B&L Technolas 217z100 laser for myopia? What are the differences between them? After undergoing laser eye surgery, is there a risk of the corneal flap being dislodged? Which proced...

Dr. Gao Pilin reply Ophthalmology
INTRALASE femtosecond laser refers to a method of creating a corneal flap using laser technology instead of a blade. In contrast, the B&L Technolas 217z100 laser system from Bausch & Lomb requires a blade to cut the corneal flap. Immediately after laser surgery, there is ...

Overcoming Anxiety in Cataract Surgery: Femtosecond Laser vs. Anesthesia

Hello, Doctor Gao. I had traditional cataract surgery on my right eye, but I felt very nervous and tense during the procedure. Fortunately, the nurse continuously reassured me to relax, and the surgery was successful. Now, I am considering cataract surgery for my left eye, but I ...

Dr. Gao Pilin reply Ophthalmology
Hello: Femtosecond laser cataract surgery is an advanced technique that offers shorter surgical times and faster recovery compared to traditional surgery. This procedure is typically performed under local anesthesia, eliminating the need for general anesthesia. However, patients ...