The physicians at Barnet Dulaney Perkins Eye Center use only the most current available technologies during every phase of the cataract surgery procedure. We have adopted all of the latest innovations, from clear corneal incisions and laser-created capsulotomies to intraoperative refractive measurements and the newest IOL designs. The result is an experience for patients that is the safest, most effective and most efficient it can be.
With the addition of the LensSx femtosecond laser, our surgeons now offer bladeless cataract surgery. Instead of performing the key steps manually, they are able to program the laser to create the capsulotomy and corneal incisions, including arcuate incisions for the correction of astigmatism, with unprecedented precision and predictability.
Studies have shown the laser creates perfectly centered and sized capsulotomies, making effective lens position and IOL power calculations more accurate and predictable, which ultimately improvespatients’ postoperative visual outcomes. The laser is also used to fragment the lens, which reduces the amount of ultrasound phacoemulsification energy required to remove it, thus enhancing safety.
The laser can be used as part of cataract surgery for most patients, with some exceptions. For example, it should not be used in patients who have certain types of corneal disease, glaucoma, hypotony, a corneal implant, a corneal opacity that would interfere with the laser beam, a poorly dilating pupil such that the iris is not peripheral to the intended diameter of the capsulotomy, or previous corneal incisions that might provide a potential space into which the gas bubbles produced by the laser can escape.
ADVANCED TECHNOLOGY LENSES
Barnet Dulaney Perkins surgeons discuss postoperative vision goals with each cataract surgery patient. Standard monofocal IOLs certainly provide excellent outcomes for patients who do not mind wearing glasses or contact lenses after surgery to see at all distances. However, those who want to reduce and potentially eliminate dependence on glasses or contact lenses once their cataract is removed can opt for a multifocal or accommodating IOL. Each type has a unique design but the same goal: clear vision at near, intermediate and distance.
Patients with corneal astigmatism that would prevent achievement of best possible distance vision after surgery can choose a toric IOL.
INTRAOPERATIVE REFRACTIVE MEASUREMENTS
Our surgeons have further refined their cataract surgery results with use of the ORA (Optiwave Refractive Analysis) System. This wavefront aberrometry-based diagnostic device determines the true refractive power of the eye and can be used to take real-time measurements during surgery. ORA can be used to measure the eye while the crystalline lens is still in place, when the cataract has been removed, and after the IOL has been implanted.
The refractive data it provides is invaluable for guiding toric IOL placement and size and location of limbal-relaxing incisions and for confirmation of IOL power selection. This technology is especially useful for patients who have had previous corneal refractive surgery that complicates accurate IOL selection. In every case, it helps the surgeon to ensure the intended refractive outcome has been achieved – before the patient leaves the operating room.