The Byers Eye Institute at Stanford is the first academic medical center on the West Coast to offer laser-assisted cataract surgery, offering unmatched precision, control and safety compared to traditional cataract removal methods. Using the Catalys® laser developed at Optimedica, a medical technology company with its roots based at Stanford, ophthalmologists at the Byers Eye Institute can now use laser technology to assist in the surgical treatment of cataracts.
Each year, three million Americans have their cataracts removed by the skilled hands of ophthalmic surgeons. But with laser technology, these same surgeons can create completely customizable microsurgical incisions with precision and reproducibility not possible with conventional techniques.
"Creating a circular opening in the lens capsule is a critical step in cataract surgery," says Artis Montague, MD, Clinical Assistant Professor and Director of Cataract Surgery Services at Stanford. "Experienced surgeons are quite good at creating these circles. I've drawn thousands of them, and can create that circular opening very well, but compare me to a laser making that circle, and the laser is going to be perfect every time."
That perfection, guided by a three-dimensional scan of each patient's eye, is just the first step. Because the laser breaks up the cataract into a latticework field of tiny squares, the surgeon then can remove the cloudy lens with far less ultrasound energy. The difference in impact and inflammation is substantial compared to the traditional surgery.
Laser technology has been used for decades to correct nearsightedness, farsightedness and astigmatisms. The challenge of using it in cataract surgery is to control the laser's intensity to avoid collateral damage to surrounding tissue, the retina and other parts of the eye, yet still to power the precise incision required for the cataract removal.
The laser device used in the surgery provides a noninvasive-imaging technique to create a three-dimensional computerized map of the eye that forms the basis for an ideal pattern for the laser to follow. That pattern is then superimposed on the three-dimensional image of the patient's eye to confirm for the surgeon that the laser is on target. It also allows the surgeon to monitor the laser's incisions.
The relatively low amount of energy needed to remove the lens reduces the risk of infection and minimizes damage to surrounding tissue, including the corneal epithelium, and other complications.
"It feels so much safer," says Montague. "Time will tell, but I think it has the potential to change cataract surgery tremendously."
This technology is also ideally suited to treat patients with astigmatism, which can be partially managed at the time of surgery using laser-assisted corneal incisions or through implantation of specially designed intraocular lenses. As placement of these toric intraocular lenses must be precise, the creation of a perfectly round surgical opening is critical for the best possible outcome.