Femtosecond Laser

March 13, 2015
A cataract is a clouding of the lens in the eye that is usually caused by aging. As people get older, the lens of the eye becomes opaque and cloudy, affecting their vision and the ability to perform their normal daily activities. While cataracts can occur in both sexes and at any age, they are far more common in older people as they are simply part of the aging process. However, people with diabetes, high blood pressure or long-term exposure to ultraviolet light may develop cataracts earlier than others.
The symptoms or signs of cataracts include clouded, blurred or dim vision. If left untreated, cataracts can ultimately result in full loss of vision and permanent blindness. 
Cataracts can be treated by removing the cataract lens and replacing it with an artificial lens. Advances in medical technology now make this a safe and accurate procedure. The old method of cataract surgery was performed by using a surgical instrument with an oscillating blade to cut the cornea flap, remove the cataract lens, and implant the artificial lens. However, this method was less precise than more recent developments and could sometimes result in tissue damage.
The revolutionary new femtosecond laser offers a safer and more effective method of cataract surgery. With computer-controlled femtosecond laser surgery, the doctor can make a precise incision that ensures the intraocular lens implantation is positioned exactly where it needs to be placed to correct the corneal astigmatism and restore the patient’s vision.
The benefits of femtosecond laser cataract surgery include an increase in accuracy and a reduction in complications after surgery. However, femtosecond laser is not suitable for everyone. It is not used for people with corneal opacity, scars or poor dilation because these conditions prevent the lasers from penetrating into the eye.
Prior to prescribing femtosecond laser cataract surgery, the doctor will review the patient’s medical history and symptoms, and perform an eye examination so as to check for other eye diseases and obtain accurate measurements for the new lens implant. The patient also needs to undergo a physical examination with an internist so as to ensure that he/she is physically healthy and free from any diseases that can be harmful during or after the surgery, or which can affect the treatment.  
After undergoing femtosecond laser cataract surgery, the patient will be able to see almost immediately and can soon return to performing his or her normal daily activities. However, it is important to monitor the eye carefully for any signs of infection, so the eye will be bandaged and kept closed on the first day after surgery. Once the bandages are removed, the patient should also avoid washing his or her face and hair for 5 days and always wash his or her hands before touching the eye.  
Cataracts never recur following cataract surgery. However, there is a possibility of capsule opacification occurring at around 5 years after surgery. In these cases, laser treatment is needed to rectify the problem. 
While cataracts are a common part of the aging process for many people, it is important that you look after your eyes to minimize the risk. Wear UV protective sunglasses when you are out in the sun and have your eyes tested regularly. People over the age of 40 should have their eyes tested annually to ensure that they keep their good vision long into old age.   
By Assoc. Prof. Dr. Ekachai Bharksuwana, Ophthalmologist, Eye Center, Bumrungrad Hospital.

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