Laser-Assisted Cataract Surgery

There are 4 steps to cataract surgery:

  1. The envelope holding the lens of the eye is surgically opened,
  2. The lens is fractured into pieces, 
  3. The pieces are vacuumed out of the eye
  4. A synthetic lens implant is inserted in place of your natural lens.

In Laser-Assisted Cataract Surgery, Steps 1 and 2 are performed by laser and Step 3 by ultrasound. In Manual Ultrasound Surgery, Step 1 is done by hand and Steps 2 and 3 are done by ultrasound. 

A computer-guided laser is more precise than even the best human hands.

Which method of cataract surgery is better?
Patients do well with both procedures. The femtosecond laser applies less energy to break apart the cataract. It is therefore not only more precise, it is also gentler in performing the first two steps of cataract surgery. Many patients undergoing Laser-Assisted Cataract Surgery have clearer vision on the first post-operative day. Consider Laser-Assisted Cataract Surgery if you have one of the following conditions:

  • Extremely dense cataract
  • Previous significant eye trauma or unstable cataract support
  • Pseudoexfoliation syndrome
  • Poor corneal endothelial cell health

Even if you do not have one of these conditions, you can have Laser-Assisted Cataract Surgery.

Does health insurance pay for both procedures?
Medicare and supplementary insurance pay 100% toward ultrasonic cataract surgery. There is an out-of-pocket additional fee for Laser-Assisted Cataract Surgery that includes correction of your astigmatism.

I’m very nervous. Will that affect my outcome?
Intravenous sedation is given to make you calm and relaxed. Most patients are surprised to learn that it is over so quickly.

Does cataract surgery hurt?
There is some pressure, but not pain with the first two steps of Laser-Assisted Cataract Surgery, while there is no discomfort with Ultrasonic Cataract Surgery.

I don’t want to see anything.
It is optically impossible to watch the surgery being performed on your own eye.




Isn’t it better to wait until the cataract is ripe?
With older-style cataract surgeries in the 1970’s that often required 60-90 minutes to perform, doctors recommended waiting until the cataract was “ripe” or vision was very poor before operating. With modern techniques that take a small fraction of that time, doctors now recommend surgery as soon as your visual symptoms – especially night driving and reading – begin causing difficulties, because both the surgery and recovery are simpler and faster, and the surgery is safer.

Which lens implant is best for me?

  • A basic monofocal lens implant will provide good distance vision only if you have a low amount of astigmatism.
  • If you have astigmatism of 1.0 or more, a toric lens implant will give you the clearest vision for distance.
  • If you have less than 1.0 units of astigmatism, a multifocal lens implant will give you the ability to see both far and near, even without glasses.

Insurance companies pay fully for a basic monofocal implant. While toric and multifocal lenses have additional cost, they also have very high satisfaction rates.