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Thursday / June 13.
HomeminewsLaser First For Cataracts

Laser First For Cataracts

In a first for the Southern Hemisphere, ophthalmologist Dr. Michael Lawless of Vision Eye Institute Chatswood recently performed the LaserLensSMA procedure on cataracts.

LaserLensSMA (SMA stands for ‘safer, more accurate’) uses femtosecond laser technology to emit extremely short pulses lasting just 50 to 1,000 femtoseconds (or quadrillionths of a second) that cut atom by atom without transferring heat or shock. It can be used on all materials – from steel through to teeth enamel and organs. The LaserLensSMA technique removes some of the necessary steps the surgeon would normally take using a knife, and reduces the amount of ultrasound energy required to perform the operation. According to the Vision Eye Institute it decreases the chance of human error and the risk of infection.

In traditional cataract surgery the surgeon uses a scalpel to cut into the eye, and then uses forceps and a needle to open the lens before preparing the cataract for suction removal by breaking it up. Dr. Michael Lawless says the femtosecond laser treatment handles all of this with absolute predictability – it creates the initial incisions, opens the lens capsule and softens the lens by dividing it into segments.

The rest of the procedure continues under ultrasonic phacoemulsification to remove the cataract and subsequently to implant the intraocular lens (IOL)

…while the LaserLensSMA has a place in cataract treatment, it’s not a necessary course of surgery for every patient

Patients remain fully conscious during surgery and have reported no pain – just pressure on the eye as the surgery is conducted.

There are currently only four LaserLensSMA devices in use around the world.

Dr. Gerard Sutton, from the Vision Eye Institute said, “We can change the refractive power of the eye whether it be short sightedness, long sightedness or a stigmatism by changing the lens inside the eye”.

The new technology, is the first good news to come from the troubled Vision Group for over 12 months and has been hailed by the Vision Eye Institute as ‘revolutionary’. However, the RANZCO has taken a more conservative approach saying it is a “small and evolutionary step in the advances in cataract surgery seen over the last 50 years”.

President of RANZCO, Richard Stawell, said that while the LaserLensSMA has a place in cataract treatment, it’s not a necessary course of surgery for every patient. “Theoretically, you can see that in certain clinical situations LaserLensSMA could make a difference but that’s at the more complex end of the cataract spectrum. There is no clinical evidence to say that it will make any difference to routine cataract surgery, which is handled perfectly well by traditional procedures.”

Mr. Stawell also questions the Vision Eye Institute’s claim that the LaserLensSMA reduces the chance of infection. “The surgery still involves the use of intraocular instrumentation as previously, so it is hard to understand that the infection rate would be less,” he said.

Neither is it going to make the surgery any quicker or cheaper for people with routine cataracts, he said.

“From what we’ve seen in the budget, there is no increase in the amount of money coming forward for cataracts and it is unlikely that the government will be offering any greater Medicare rebates for this treatment. The laser equipment will be expensive to buy and practices will need to recoup their costs – which means patient expenses will increase for this type of cataract surgery.”

Cataract surgery is the most common eye operation in the world. Every year over 16 million cataract operations are performed worldwide, 190,000 of which are carried out in Australia.

Age is the single most important risk factor in cataracts. As such, the volume of cataract surgery is expected to continue to increase with our aging population.