The VICTUS Cataract Laser
The femtosecond laser was first used to improve accuracy and safety when creating the flap needed in LASIK surgery. But this technology has now been brought to cataract replacement lens surgery. Dr. Aizuss uses the VICTUS femtosecond laser for all of his laser cataract surgeries. He believes the VICTUS laser to be a superior option for his patients who desire femtolaser assisted cataract surgery.
Who is an ideal candidate for cataract surgery?
The ideal candidate for cataract surgery is someone who has noted slowly progressive worsening of vision due to cataract formation. Symptoms of cataracts include increased glare from headlights and taillights, blurring of street signs or blurring of words on television, decreased contrast sensitivity under dim lighting conditions or difficulty perceiving color differences in lower light levels. Almost anyone can do well with cataract surgery regardless of their general health and it is not necessary to stop any of one’s current medicines including blood thinners.
How is the VICTUS laser used in cataract surgery?
Cataract surgery involves making an incision in the cornea to access the cataract-clouded lens behind it. That lens is then broken up and vacuumed away. An artificial intraocular lens is inserted to replace the natural lens.
Dr. Aizuss uses the VICTUS laser for some of the steps of the procedure.
- For the corneal incision
Dr. Aizuss does not presently use the femtolaser to construct his corneal incisions. For this part of the procedure, Dr. Aizuss believes that incisions created with a precise diamond blade provide better control and seal better thus decreasing the risk of postoperative infections.
- For the capsulotomy
Next, an incision must be made in the capsule that holds the cataract-clouded lens. This is called an anterior capsulotomy. The goal is to gain access to the lens, but to not remove the capsule. The remaining capsule will then be used to hold the artificial intraocular lens.The front portion of the capsule is removed, but it is imperative for the remainder of the capsule to remain intact. Whereas a needle or forceps is used to tear the capsule in traditional cataract surgery, Dr. Aizuss uses the VICTUS laser for this incision on patients who undergo femto-laser assisted cataract surgery or FLACS. This makes the capsulotomies more accurate and reproducible time after time. This accuracy may enable better centering of the IOL, which may improve the quality of the final visual outcome.
- Lens and cataract fragmentation
Now the clouded lens needs to be accessed, broken up, and removed. This was done in traditional cataract surgery with an ultrasonic device that was inserted into the capsule incision. Breaking up the cataract lens is called phacoemulsification. When done with ultrasound energy, heat can build up in the incision. This can burn the incision and negatively impact the visual outcome. It can actually induce astigmatism in the eye. While such a complication is extraordinarily rare in Dr. Aizuss’s skilled hands, the femtolaser or FLACS procedure further reduces the risk of heat build up in the incision by softening the cataract.When Dr. Aizuss uses the VICTUS laser for phacoemulsification, the laser softens the cataract as it breaks it up. This breaks the cataract into smaller, softer pieces that are easier to then vacuum away. This requires less energy, so the chances of burning the incision are dramatically lowered. The laser also result in the need for less ultrasonic energy in the eye which may result in less endothelial cell loss during the surgical procedure which ultimately is better for the long-term health of the cornea.The laser also may reduce the chances of damaging the capsule during the surgical procedure. This is critical for accurately holding the IOL in place.
- Astigmatism correction
If the patient has astigmatism, where the shape of the cornea is more oblong than round, this can now be corrected during cataract surgery. Small incisions are made in the cornea to make the cornea more round. These are called limbal relaxing incisions. Formerly, these were made with a diamond blade. Dr. Aizuss uses the VICTUS laser to make these incisions. These can now be precisely planned and made with increased accuracy, increasing the odds that the patient will not need eyeglasses to correct his or her astigmatism after cataract surgery.In almost all patients, Dr. Aizuss prefers to correct astigmatism with astigmatism correcting lenses known as toric lenses. However, there are some circumstances where there is less astigmatism to be corrected than the minimum amount corrected by a toric lens where using the femto laser enables correction of the astigmatism without making less precise incisions in the cornea by hand.
How is the VICTUS laser a better option for laser cataract surgery?
The VICTUS laser is FDA approved for laser cataract surgery. Dr. Aizuss believes it to be the best option in available femtosecond lasers. Here are some advantages to this laser:
- VICTUS features Advanced Docking Technology that minimizes the possibility of eye tilt or distortion and enables precise alignment designed to maintain the natural shape of the eye during laser cataract surgery.
- The system provides live online viewing of the OCT throughout the entire procedure.
- VICTUS offers a wide range of cataract lens fragmentation patterns: spider web, grid, radial, and circular. This allows the fragmentation pattern to fit the lens shape more accurately.
- The energy used in lens fragmentation can be adjusted according to the cataract grade.
Are there side effects with laser cataract surgery?
This is a very safe procedure with few complications. The accuracy of the VICTUS laser in planning and making the necessary incisions makes for better healing and better end vision. One complication/side effect is the possibility of subconjunctival hemorrhage. But this dissipates quickly after the procedure is completed.
How long does laser cataract surgery take?
Dr. Aizuss performs these procedures in just 10-15 minutes.
Is recovery different with laser cataract surgery than traditional cataract surgery?
Recovery is the same. There can be some initial blurriness during the immediate postoperative period. Your eye and entire visual system needs some time to heal after the removal of the cataract and adapt to the intraocular lens that replaced it.
Many patients report clear vision within several hours after cataract surgery, but others may need a few days. Sometimes patients report some dry eye or a feeling of scratchiness in the eye after cataract surgery. These symptoms subside quickly, usually by the next morning, as your eye heals.
Most eyes are considered fully healed by one month after surgery when the postoperative medications are discontinued.