Laser Cataract Surgery
In suitable patients, up to two thirds of cataract procedures are now performed by LenSx at our practice. Patients are choosing LenSx due to its added precision and reliability. Other reasons include the state of the art technology, its application and the comfort and ease of the procedure. The procedure using LenSx is being proven to be as safe as conventional cataract surgery.
A significant Australian trial of 1400 participants showed that it is safer than all published trials of cataract surgery under key indices. The eye receives less wear and tear from this procedure as less internal energy is utilised during the procedure than standard procedures.
The surgery experience only differs slightly from standard surgery. The laser treatment is performed in a dedicated laser room. The laser interface docks painlessly onto the anaesthetised eye and the procedure takes only two minutes in total. We then move into the operating theatre where the procedure is completed in the usual way.
Post op results are positive with patients being very happy with the procedure and outcomes.
Laser cataract surgery has allowed eye surgeons to substitute the first three manual steps of the operation. These three steps include the surgical incisions to the cornea, the formation of the
capsulotomy and the gradual fragmentation of the original lens. Traditionally, surgeons would use a hand-held metal or diamond blade to make the incision where the sclera meets the cornea. However, laser technology now provide surgeons with a sophisticated 3-D image of the eye called an OCT (optical coherence tomography). The image ensures the incision will be of a precise location, length and depth. The technology removes the variability of surgeon practice, improves incision accuracy and may reduce the risk of infection.
Once the incision is made, the front portion of the capsule is removed to gain access to the cataract; a process called capsulotomy. Damage to the capsule is to be avoided, as the capsule will hold the artificial lens in place. Once an opening in the capsule is made, the capsule is torn in a circular motion, creating an opening of 5 to 6mm in diameter and well centered for the optimum implementation of the new lens. By using laser technology, this precise and technical process improves overall accuracy of the capsulotomy, leading to better positioning of the intraocular lens (IOL). Correct placement of the IOL considerably contributes in determining final vision results for patients.
The cataract is then removed after the capsulotomy process is complete. The laser method enables the original cataract to be softly broken into small pieces, requiring less energy than traditional surgery. The process of removing the cataract using laser surgery also reduces the possibility of capsule breakage. Besides the calculation of the correct implant power required, a key factor for superior vision is the preservation of the capsule where the original lens was initially located. It is important to reduce overall damage of the capsule so the artificial lens can be implanted correctly for optimal vision.
Your surgeon and staff can help you with finding information about costs and whether cataract surgery is the right treatment for you.
Diabetic Eye Screening and Treatment
Diabetes causes damage to the blood vessels in the back of the eye. This can lead them getting blocked or getting damaged and then leaky or bleeding. The longer someone has diabetes, and the poorer their control, the more damage there is. However even with excellent diabetes control, over time there is still blood vessel damage. The problem is that if you wait until you notice a problem with the vision it is often too late. There can be really very severe damage to the blood vessels in the eye and your vision can still seem completely unaffected. You need to have treatment BEFORE you notice anything wrong with your vision. This is why it is critical that ALL people with diabetes have their eyes thoroughly examined at least every two years in order to detect the damage while it can still be treated. The great news is that if it is caught in time we have excellent treatment that can mean preserving vision in most people.
Screening
Looking for diabetes damage is simple and just involves having some drops to dilate the pupil and then looking inside the eye with a bright light and sometimes taking a photograph. The vision will be a bit blurry for a couple of hours. If some damage is evident then some other tests including OCT (a special high resolution scan of the retina) or angiography (where some dye is injected into a vein in your hand and then some photographs taken ) may be required to assess the degree of damage. If only minor disease is detected no treatment may be needed but you will need to be rechecked more often to see if it is getting worse.
Treatment
The best treatment is not to get the damage in the first place. Controlling both the diabetes and the blood pressure as tightly as possible will minimise progression of the eye disease. Your surgeon at Hobart Eye Surgeon will liaise with your GP and diabetes specialist to try to achieve this.
Once there is some diabetic retinopathy many people will benefit from starting a tablet called fenofibrate. This is a type of cholesterol lowering tablet that has been shown to slow down the progression of the eye disease regardless of cholesterol level.
If the diabetic eye disease becomes vision threatening then there are two main treatments that can be used and are available at Hobart Eye Surgeons. The first of these is laser treatment. Here a focussed laser beam is used to treat the retina and can be very effective at halting progression of advanced diabetic retinopathy. It is performed in the clinic taking 5-10 minutes per session but sometimes requiring several treatments. It is a little uncomfortable but mostly well tolerated.
The other newer treatment is injections into the eye of powerful medicines called anti VEGF drugs. These can stop the damaged blood vessels leaking. They may need to be given every month for one or more years but can be extremely effective at halting vision loss and sometimes restoring vision that has been lost. These injections are given at Hobart Eye Surgeons’ Argyle St and Rosny branches and are usually painless.
More information
There is excellent detailed information about diabetic eye disease on the Macular Disease Foundation website and printed forms of this are available in our clinic waiting rooms.
Hobart Eye Surgeons Hobart address and phone