Cataract surgery stands out among the most common and successful surgical procedures performed worldwide. It’s proclaimed a boon for gifting millions of people with the gift of clear vision.
As new technologies keep on pouring, patients often oscillate in dilemma as to which specific surgical procedure to go for. Yet, the two most noted surgical procedures are Phacoemulsification (Phaco) and LASER-assisted cataract surgery.
Both of the surgical procedures attempt a common mission of removing the clouding lens and implanting a clear intraocular lens to restore vision but they do differ in their mode of operation. Misconceptions often spread like a fire in the forest. It’s time to debunk them to help patients make an informed and unregretful decision.
Understanding the Basics
Phacoemulsification (Phaco):
For decades, Phacoemulsification stands as the gold standard among the various cataract surgical procedures. In this procedure, the surgeon attempts a small incision in the cornea to let in an ultrasonic probe. This probe eventually splits the cloudy lens into fragments, which are then suctioned out. A foldable intraocular lens is then implanted in the place of the cloudy lens.
LASER-assisted Cataract Surgery:
This includes the latest technology in operation, wherein the femtosecond laser is combined with traditional cataract surgery. This LASER performs multifold tasks – starting with an initial micro-incision to softening the cataractous lens, and finally creating a precise opening in the anterior lens capsule. This technique involves the reduction in the amount of ultrasonic energy required to break up the lens. Thus, they minimize the chances of trauma to the eyes.
Myth 1: LASER Surgery is Completely Non-Invasive
The most prevalent myth is LASER cataract surgery is a completely non-invasive procedure, while Phaco involves an incision and, therefore labeled to be traumatic. However, both procedures start with a micro-incision in the eye.
The Reality:
LASER-assisted cataract surgery uses a laser to make the incisions, which are pinpoint and devoid of human error. After the initial micro-incision is made, the rest of the procedure of fragmenting the lens, removing the lens debris, and implanting the IOL is quite similar in both cases. It does require some level of human or manual intervention.
Myth 2: LASER Surgery Guarantees Better Results
Patients often presume ‘the newer the technology, the better’. The presumption is that the laser technology is essentially superior and its outcome better than Phaco.
The Reality:
Both LASER-assisted cataract surgery and Phacoemulsification do have high success rates. Yet, the outcome truly lies in the surgeon’s skill rather than the technology chosen. While lasers can offer more precision but cannot be held solely responsible for better vision post-surgery. The outcome does depend upon the patient’s overall ocular condition, other underlying medical conditions, the type of the IOL used, and appropriate post-operative care.
Myth 3: LASER Surgery is Safer
Yet, another misconception attributed to LASER-assisted cataract surgery is, that it is far safer than the traditional Phaco with fewer complications and faster recovery time.
The Reality:
Both LASER-assisted cataract surgery and Phaco are reasonably safe with lesser complication rates provided that there are no severe underlying medical conditions. But, since LASER technology does reduce the need for ultrasonic energy, it results in lesser corneal swelling and enhances recovery faster. The basic difference in safety as portrayed is a myth. The complication arises post-operatively due to faulty techniques or patient’s adverse underlying medical conditions or negligence in abiding by the post-operative regime.
Myth 4: LASER Surgery is Pain-Free
Patients believe LASER-assisted cataract surgery to be painless while Phaco is associated with discomfort before and after the surgical procedure.
The Reality:
Both of the surgical procedures are performed under local anesthesia to refrain the patient from pain sensation during the procedure. But, minimal discomfort, mild irritation, and dryness are often encountered post-operatively which eventually subsides within a few days with medications.
Myth 5: LASER Surgery is Necessary for Complicated Cases
Another misconception prevalent is for complicated cases like hard or mature cataracts, LASER technology should be attempted.
The Reality:
LASER-assisted cataract surgery can be advantageous in certain complicated cases. But, experienced surgeons undoubtedly can handle the same with Phaco. It’s the surgeon’s discretion in such cases to be accepted and not to blindly follow the misconception.
Making an Informed Decision
When it comes to choosing one of the two- Phaco or LASER-assisted cataract surgery, it should be the consultant’s or surgeon’s discretion. Both surgical procedures have their own sets of pros and cons. Therefore, the choice of the procedure will largely depend upon the patient’s ocular health, the severity of the underlying medical conditions, and the surgeon’s expertise.
Humanizing the Decision
Patients do get carried away with the technical details and marketing hype when considering cataract surgery. Irrespective of the procedure chosen, what matters the most is the outcome – restoring clear vision and improving quality of life. Imagine post-operatively, you see the colors brighter, the details sharper, and everything in focus. That’s the after-effect of a successful cataract surgery irrespective of the procedure chosen, whether PHACO or LASER-assisted cataract surgery. For making an unregretful decision, consider not only the technology but rather the surgeon’s expertise as a compassionate and skilled surgeon’s success rate is by far large and cannot be replaced by any new technology. The technologies are human creation and the creation cannot enslave the creator.