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gery with unmatched refractive outcomes. In my opinion, it's time for forward
thinking. Adding lasers now will put your facility on the cutting edge of care and
position it to meet the future demands of rising patient expectations.
Perfect cuts, every time
The laser's primary clinical benefit is realized during creation of the capsu-
lorhexis — the large circular incision in the anterior lens capsule. Studies have
shown the capsulorhexis needs to offer predictive size and a precise diameter,
and be perfectly centered in order to improve a patient's post-op vision. Manual
techniques result in successful capsulorhexis most of the time, but the human
element makes the cuts imperfect, however slight the imperfections might be,
which might cause the implanted intraocular lens to shift over time. Creating a
perfectly circular, perfectly centered capsulorhexis with a laser, however,
results in more predicable refraction with less astigmatism and more precise
vision outcomes.
Even a slight improvement in the accuracy of manual techniques is valuable
when considered in the context of rising patient expectations. Patients don't
want to simply see better after cataracts are removed, they want to see with
near-perfect vision, without the aid of glasses.
Small improvement to the creation of the capsulorhexis is nice, but a more
important consideration is the laser's current ability to reduce the amount of pha-
coemulsification power used and its ultimate future ability to remove phaco from
the surgical equation altogether, eliminating the leading cause of complications
in a relatively safe procedure.
One of the most common, and feared, phaco-related complications is ruptur-
ing of the capsular bag, caused by the horizontal or vertical movements of the
sharp phaco tip. Corneal edema, inflammation caused by the ultrasonic energy
that can result in long-term cornea failure and needed transplantation in some
cases, is also a concern.
Even though the risks of both adverse events are small, breaking the capsular
