Eye surgeons from the Asia Pacific region have turned to Vision Eye Institute (VEI) for guidance on ground-breaking laser cataract surgery procedures.
VEI ophthalmologist Dr. Michael Lawless has just completed an introductory training program for prominent Japanese eye surgeon Dr. Yamazaki. He has also introduced the femtosecond laser device and processes to ophthalmologists from India, Singapore, Malaysia, Philippines and New Zealand.
Dr. Lawless said VEI’s role in introducing laser cataract surgery came about because of a long held relationship between himself and LensX, the developers of femtosecond laser technology.
“I have known LenSx’s research and development team since they developed the femtosecond laser for LASIK surgery and the challenge of bringing laser precision to cataract surgery was a logical next step.
Ophthalmologists at Dalcross Hospital on Sydney’s upper north shore, in Melbourne, Launceston and Hobart have invested in the femtosecond cataract laser
LenSx conducted initial treatments of laser cataract surgery with Professor Nagy in Budapest, Hungary.
“I was invited to perform surgery with Professor Nagy in February 2011 and by April VEI had imported a device into Australia,” said Dr. Lawless.
Safer, More Accurate
Within the eye care profession, there is debate over whether laser surgery is safer and better than manual cataract surgery. On one hand, the technology adds to the cost and complexity of cataract surgery. On the other, laser is a more accurate and reproducible way to make an incision, open the front of the cataract and break it into pieces.
Dr. Lawless believes laser technology makes cataract surgery safer and more accurate. “That’s a big deal for the individual but there’s also a flow on effect to society and eye care professionals,” he said.
“However, we need to be able to measure the benefits of laser cataract surgery and that takes time, data and experience. That’s something that VEI is able to do. We have experience in conducting clinical trials and have eight surgeons all using the technology. The data we’ve collected over the last year is helping to identify any problems that arise – and you’d expect problems as this is an entirely new procedure – and determine whether the procedure is in fact more accurate and safer.”
Around the world there are already 116 lasers for cataract surgery installed. Five of them are in Australia. Twenty-seven thousand cataract procedures have been completed globally, 1,600 of those here.
“Ophthalmologists at Dalcross Hospital on Sydney’s upper north shore, in Melbourne, Launceston and Hobart have invested in the femtosecond cataract laser and there will be three more installations on the Eastern Seaboard this year,” said Dr. Lawless. “Here at VEI, even our most conservative surgeons have embraced the technology. There’s very little in it financially for the individual doctor, but it’s become the preferred device for all of us.”
Dr. Lawless said that due to the cost of the device, laser cataract surgery won’t suit every facility. “A day surgery that performs 200 cataract procedures in a year won’t take this on. It’s more suited to groups of surgeons who visit the same facility. I can see that over time, as more technology like this becomes available, the profession will change, ophthalmologists will start to amalgamate so that they can make the necessary investment.”
Taking Technology to Tokyo
Japan has traditionally held a reputation for innovation but not when it comes to laser cataract surgery. Dr. Yamazaki from Tokyo spent two days with Dr. Lawless in Sydney recently to learn how the technology is used. He will become Japan’s first ophthalmologist to practise cataract laser surgery and he will introduce many more Japanese surgeons to the procedure.
“I met Dr. Yamazaki in Chicago at the American Society of Cataracts and Refractive Surgery. He’s a fantastic guy – 41 years old and very highly respected in his field,” said Dr. Lawless.
During the devastating earthquake that rattled Japan in March 2011 and triggered a massive tsunami, Dr. Yamazaki was conducting manual cataract surgery on a patient. As the building swayed, he completed the surgery then approached two elderly women in the waiting room. “We all thought we would die that day, that the whole village would die, so I asked them whether they wanted to proceed with the surgery,” Dr. Yamazaki told Dr. Lawless. I wanted to go home but they wanted the surgery. They were very calm and they wanted to continue with their routine. So I completed the surgery and two days later, they came back to be checked. We weren’t far from the epicentre of the earthquake but we all survived,” he said.
Dr. Lawless said that Dr. Yamazaki has an extraordinary philosophy for life. “Dr. Yamazaki showed me a picture of cherry blossoms and explained to me the significance of the cherry blossom season in Japan. He told me ‘this time in my life is my cherry blossom season – my time to grow’. He wants to improve his English, to lecture and to take laser cataract surgery back to Japan and share it with other eye surgeons – he doesn’t want to keep it to himself.”
Having spent two days observing laser cataract procedures with Dr. Lawless, Dr, Yamazaki has returned to his Tokyo practice. “He will take delivery of the device very soon then a team from the States, where the technology is manufactured, will arrive in Tokyo and spend a week with him, guiding him through the first surgeries.”
Dr. Lawless said Dr. Yamazaki will then go on to train other Japanese ophthalmologists. “He will be the focus of laser cataract surgery in Japan. He will introduce the technology and guide the surgeons through the process, just as I have guided him.”
For more information on femtosecond laser technology, read the article in this issue of mivision on page 43 ‘Femtosecond Lasers in Cataract Surgery: What You Need to Know’.
