I'm a 56-year-old woman with about -12.5 in each eye. A few years ago I was advised against lens replacement surgery because of the risk of retinal detachment. I've now been told that they may go ahead as the new all-laser operation causes less trauma to the eye and lowers the risk of RD. I'm waiting to have an appt with the surgeon and will discuss it further. I'd be interested in any other views on this development.
The femtosecond laser (cost to physician $500,000) is a fantastic new instrument. The cost disadvantage is huge as there are no studies that show that in large propsective studies it improves the final result.
Studies have shown it makes a more precise incision (less likely to leak), a perfect opening in the anterior capsule (capsulorhexus), can be used to reshape the cornea to eliminate cornea astigmatism, and can fracture hard cataracts making them easier and safer to remove.
It often takes more time to do, requires more personnel and will likely cost the patient over $1000 out of pocket above insurance/eye.
It has not been shown to reduce the risk of retinal detachment in prospective studies. What might be inferred is that in difficult cases by making the surgery technically easier it might reduce the risk of capsular tear and vitreous loss which would lower the risk of RD.
This is a classic cases of cost vs. quality. In the early 80's medicare paid about $1200 for a cataract removal and inseertion of IOL and 3 months of office care. In 2013 they pay about $670. Since the year 2000 Medicare payments to physicians have increase a total of 4% (now 2% with the sequester) while expenses have risen 20%. This has stifled development of new techniques for surgery and research for eye disease.
The best solution in the USA would be for Medicare and insurance companies to allow patients to pay extra for these advanced techniques. They already do that in the case of people opting for toric and accommodating/refracting IOLs.
If I were having cataract surgery i would pay $1000 dollars extra per eye to have an experiences surgeon use the femtosecond laser. In countries with socialied medicine like UK, Canada because of costs this new technology will not be added unless it is done in the private market.
How long has the femosecond laser been used for cataract surgery? There are no long term studies yet regarding if there is corneal endotheial cell loss, which is my concern. Femosecond laser have been used in lasek surgery, correct? It does not do the actual reshaping of the cornea but does the circular cut around the out eye that is usually done with a surgical blade in both regular cataract and lasek surgery...is that correct? My opthalmologist is highly skilled in using the femosecond laser, but I am still cautious and want another opinion from another Dr. who has experience working with a vitrectomized eye. Less trauma is my main concern and it seems the femosecond laser helps break up the lens quicker and with less complications.
Thank you for your opinion on this...any Dr on this site.
I am new to MedHelp.
Can anyone help me by comparing the new LensAR with the LenSX. I know the LensAR has not been around for very long, but I understand it has a better imaging system and, with an interoperable abberometer which I thing is also fairly new, corrections can be made during the operation.
Also since I am not very bright these days, I would appreciate any corrections indicated in my thinking. I am preparing for my first cataract surgery in my left eye (-2.25 -2.50 axis 175 w /2.75add) and am tending toward the Truline IOL .
I'm afraid that finding a surgeon that's a excellent Ophthalmologist with experience in the LensAR (which I think might be better) and with experience with the Truline might be a major challenge for me.
Any thoughts and experience would be appreciated.