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O P H T H A L M O L O G Y
T
o cut with a laser or with a scalpel? In cataract surgery, the
machine vs. manual debate has been raging ever since femtosecond laser cataract surgery made its U.S. debut a little
more than a year ago.
It's easy to see the allure of surgeons removing cataracts without
a scalpel. So-called "bladeless"
laser cataract surgery promises
greater precision and improved
vision outcomes when compared
to manual techniques. Even the
most skilled of surgeons won't
"Do patients with
laser-created incisions see better than
those with manuallycreated incisions? So
far, the answer is no."
— Lawrence Piazza, MD
make the exact same incision with a scalpel every time. Yet for all its
promise, surgeons thus far have been slow to jump on the bladeless
bandwagon. Fewer than 100 laser systems have been sold to date.
Perhaps because facilities face significant start-up costs (the machine
costs about $500,000), per-click charges and $50,000 in annual maintenance fees, which they must recoup by up-selling patients willing to
pay $1,000 per eye out-of-pocket for returns to near-perfect vision.
Medicare and insurance don't cover the laser's use.
We talked to ophthalmologists to find out if the addition of the laser
to cataract removal is the next big thing or an overhyped, overpriced
luxury you and your patients can simply do without.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | N O V E M B E R 2012
