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Question about laser assisted cataract surgery
In the past, I've read a few accounts here of patients who've had the laser (Femto) and did not have adverse reactions that I can recall. In fact results were good. However, I know Dr. H. as well as other articles I've read are very cautionary (no better results, more expense) and studies are even out there that show that certain risks/side effects/adverse reactions are more likely to occur with use of the Femto laser on this procedure. (sorry I forgot what they were but I can name the MD author if needed). I know it's all a very individual thing... depends on the person, one's eye conditions etc., but it'd be interesting to read some more input on this .... especially b/c the eye surgeons I've asked for information so far both use laser assisted...I think they all do as a matter of course at this center (It is a excellent major eye center!). Surgery is not soon -but in future .....thanks.
You just said it all. Adds considerably to expense; has not been shown to be safer; may have a higher complication rate in the first 50-100 cases; it should not be 'routine' since it saddles the patient with technology that has to be paid for out of the pocket, all patients should be able to 'opt out' of expensive technology. If you are rolling in money that's fine.
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Extra cost wasn't mentioned, just that laser is used for the procedure. When I do more inquiring into it I will find out about charges etc. and if they offer clear options/choices.
Laser surgery always (or at least almost always) costs extra out of pocket. If nothing else there are usually (perhaps always) "click" fees surgeons need to pay to the vendor for each use of the laser which they are rationally going to pass on to the patient.
In my case when I traveled to get the surgery a couple of years ago, in a lower cost country (I think they vary click fees by country), the added cost was negligible but I decided not to bother, the surgeon agreeing there was no real benefit in my case. (he viewed the benefit of the laser at the time as still being mostly for either special cases like mature cataracts or for less experienced surgeons to provide more consistent results).
Everything I'd seen suggested laser cataract surgery hadn't yet proven its benefit for simple cases (and I don't think it has since either based on the studies I've seen, but I haven't kept as up to date), that it merely had different sets of rare complications. (and some surgeons noted advantages to doing it by hand, like getting a sense of the fragility/characteristics of the capsule while making the initial incisions by hand to guide them as to how to handle the rest of the procedure, though I don't know how many agree or how much of a difference that makes when presumably they tread as lightly as possible anyway when doing the rest of the procedure).
Unfortunately of course studies take time to do, and often involve multiple models of lasers and so if some new laser (or software update of one) did have benefits over conventional surgery, then it would take time for studies to demonstrate that, so it may be that some laser(s) do have a benefit that will be demonstrable, though its likely going to be small.
Everyone needs to decide their own preferences of course. In my case although I was willing to go to some trouble to be an early adopter of new technology, the Symfony IOL, I didn't choose to bother with the new technology of the laser. Having worked in leading edge areas of the computer field I've seen first hand that some new technologies make sense to adopt quickly due to actual features/benefits that didn't exist before, others may get adopted prematurely due to the "cool" technology even if they don't necessarily provide an improvement over prior methods yet but merely have the potential to do so in the future. Of course some folks may decide the Symfony is also not a new technology they think worth the tradeoffs, but at a minimum it does always have different results (for better or worse) than other IOLs, whereas there is debate over whether there is a noticeable difference with laser cataract surgery.
I'm actually surprised how many people who experienced bugs with their personal computers are willing to put their eyes in front of lasers controlled by computer software :-) Though having a software engineering background I realize the sort of stringent testing and development that must be used for that type of software, and that there doesn't seem to be a major issue with glitches, which is why I wouldn't be concerned about getting a lasik/PRK tweak for one eye eventually which impacts even more surface area of the eye.
In my case when I traveled to get the surgery a couple of years ago, in a lower cost country (I think they vary click fees by country), the added cost was negligible but I decided not to bother, the surgeon agreeing there was no real benefit in my case. (he viewed the benefit of the laser at the time as still being mostly for either special cases like mature cataracts or for less experienced surgeons to provide more consistent results).
Everything I'd seen suggested laser cataract surgery hadn't yet proven its benefit for simple cases (and I don't think it has since either based on the studies I've seen, but I haven't kept as up to date), that it merely had different sets of rare complications. (and some surgeons noted advantages to doing it by hand, like getting a sense of the fragility/characteristics of the capsule while making the initial incisions by hand to guide them as to how to handle the rest of the procedure, though I don't know how many agree or how much of a difference that makes when presumably they tread as lightly as possible anyway when doing the rest of the procedure).
Unfortunately of course studies take time to do, and often involve multiple models of lasers and so if some new laser (or software update of one) did have benefits over conventional surgery, then it would take time for studies to demonstrate that, so it may be that some laser(s) do have a benefit that will be demonstrable, though its likely going to be small.
Everyone needs to decide their own preferences of course. In my case although I was willing to go to some trouble to be an early adopter of new technology, the Symfony IOL, I didn't choose to bother with the new technology of the laser. Having worked in leading edge areas of the computer field I've seen first hand that some new technologies make sense to adopt quickly due to actual features/benefits that didn't exist before, others may get adopted prematurely due to the "cool" technology even if they don't necessarily provide an improvement over prior methods yet but merely have the potential to do so in the future. Of course some folks may decide the Symfony is also not a new technology they think worth the tradeoffs, but at a minimum it does always have different results (for better or worse) than other IOLs, whereas there is debate over whether there is a noticeable difference with laser cataract surgery.
I'm actually surprised how many people who experienced bugs with their personal computers are willing to put their eyes in front of lasers controlled by computer software :-) Though having a software engineering background I realize the sort of stringent testing and development that must be used for that type of software, and that there doesn't seem to be a major issue with glitches, which is why I wouldn't be concerned about getting a lasik/PRK tweak for one eye eventually which impacts even more surface area of the eye.
Thank you Dr and Software Developer.
Sure and best of luck
I'm just doing research in advance ... I have a significant cataract in one eye but hardly any in the other, so vision remains good, but eventually I'll want to have it done. I just keep re evaluating it and I have 4 to 6 month check up times.
Someone in my immediate family is having cataract surgeon soon and we are not using femto laser or ORA technology
Someone in my family out of state just had one eye done and I have no clue what he had but I'll certainly be interested to know. Also, I have a lot still to learn, since I don't recall just what 'ORA' technology is. I only know that the cataract surgeon I have had an initial consultation with (I had originally planned on it sooner) is very experienced. I know you've also addressed anesthesiology questions, Dr. Hagan, with several posters here, and that's another subject I will think about again before my future consultation(s).
Yes lot to consider.
Thanks to all for your input on this important subject.
Some sources claim femtolaser assist uses a smaller incision that will heal faster than in standard surgery with a blade. Also claims that there is less trauma during the breakup of the natural lens, with less of a risk of burning.
However the Shiley eye center affiliated with a major local university (UCSD) where patients have come from across the country for eye surgery, doesn't have femtolaser, only ORA. This is in contrast to the many local big Lasik eye practices that also do laser cataract surgery and promote femtolaser as a big advantage. That made me wonder about it!
Some sources claim femtolaser assist uses a smaller incision that will heal faster than in standard surgery with a blade. Also claims that there is less trauma during the breakup of the natural lens, with less of a risk of burning.
However the Shiley eye center affiliated with a major local university (UCSD) where patients have come from across the country for eye surgery, doesn't have femtolaser, only ORA. This is in contrast to the many local big Lasik eye practices that also do laser cataract surgery and promote femtolaser as a big advantage. That made me wonder about it!
I wonder if this is a similar issue regarding robotic assisted surgery in general, not just for eye operations?
Robotic surgery is a wholly different deal. It has been proven for many procedures like prostate and brain surgery.
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