Laser-Assisted Cataract Surgery in Boulder County
Femtosecond Laser Surgery can improve precision and outcomes
by Ken Kreidl, MD
Ophthalmology at Boulder Medical Center
Femtosecond Laser-Assisted Cataract Surgery (FLACS) was approved by the U.S. Federal Drug Administration (FDA) in 2010. You may already be familiar with the femtosecond laser — its been used since 2001 in LASIK surgery to correct nearsightedness, farsightedness, and astigmatism. The same laser technology is lauded as a way to potentially provide more refined and predictable results during cataract removal surgery.
Cataract surgery is most commonly performed using a technique called phacoemulsification, also known as phaco. Traditional phaco surgery uses sound waves to break up the crystalline lens that has hardened over time into a cataract. FLACS can improve upon traditional phaco techniques and is approved for use in the following steps during cataract surgery:
Most cataract surgery requires two initial incisions into the sides of the cornea. These incisions are beveled so that they act like a door and become self-sealing from the pressure in the eye. Traditionally made with a surgical blade called a keratome, the femtosecond laser can also make these incisions into the tissue. Precise incisions are critical for self-sealing and to prevent infection.
Curvilinear Capsulorhexis — Opening the Lens Capsule
After the incision is made, the next step is to open the lens capsule to access the cataract. This procedure, called curvilinear capsulorhexis, is traditionally done with a capsulotomy needle to make a tiny flap, then Utrata forceps are used to complete the procedure. The laser does this step by cutting the opening in a circular manner and removing the cut circular anterior capsule with forceps. A centered, circular capsule is essential for good intraocular lens placement.
In order to remove the dense cataract through the small incision, it must be broken up into smaller pieces and vacuumed out of the eye. The phaco technique does this with sound waves that act like a microscopic jackhammer within the eye. The femtosecond laser, on the other hand, breaks the lens into pieces before entering the eye so that less phacoemulsification energy is required to break up the cataract. The phacoemulsification handpiece is then used to vacuum out the pieces.
Limbal Relaxing Incisions for Astigmatism
For patients with astigmatism, toric intraocular lenses are the most accurate technique to improve astigmatism during cataract surgery. Small limbal relaxing incisions on the edges of the cornea can be precisely made with the laser to fine-tune the correction of the astigmatism.
In summary, although traditional phaco surgery is remarkably safe and effective for cataract removal, the femtosecond laser can help surgeons improve accuracy and outcomes. Ask your ophthalmologist if you are a candidate for Femtosecond Laser-Assisted Cataract Surgery or contact the Boulder Medical Center ophthalmology department for an appointment at (303) 440-3049.
Dr. Kreidl, originally from San Francisco, started his ophthalmology practice at Boulder Medical Center in 2004. He and his wife, Ryn, a pediatrician, have two children, Luke and Max. Dr. Kreidl loves mountain biking and skiing with his family, and was a nationally ranked tennis player before becoming dedicated to medicine.
Dr. Kreidl offers a full range of ophthalmology services and treatments including:
- Surgery – Crystalens and Trulign accommodative lenses
- Glaucoma – SLT, ALT, LPI
- Diabetes – Retinal laser surgery
- Dry Eyes
- Eyelid surgery
- Eye Trauma
- Complete eye exams
- Contact Lenses