Cataracts are a cloudiness that develops throughout the normally clear crystalline lens of the eye. The cloudiness is not a surface phenomenon that could conceivably be removed from the lens. They are usually observed in older patients but can develop earlier due to certain chronic medical conditions. Some types of eye surgery can also increase the incidence of early cataract formation. Standard treatment for cataracts is the removal of the cloudy lens and replacement with an artificial lens.
Surgical treatment once involved a scalpel and sutures, but it is now routinely performed with extremely small incisions that heal without requiring suturing. The damaged lens is shattered with sonic pulses and replaced with a collapsible polymer that can be inserted through an incision much smaller than the final diameter of the lens. Cataract surgery is an intricate, precision operation that requires the full attention of a highly skilled surgeon.
But that requirement is changing. New femtosecond laser assisted cataract surgery, known by the acronym FLAC, enables incredibly precise laser entry into the ocular lens capsule. Ultra-fast energy pulses from the laser break the lens apart on a molecular level and a replacement lens is inserted into the capsule. Although the lens is still removed, it is thought that continuing advances in technology may someday essentially dissolve the cloudy lens and negate the need for physical removal.
Work that once required a skilled surgeon can now be performed by a surgeon with average abilities or even by a medical technician with cutting edge equipment and a complex computer program. The equipment operator may even perform the operation remotely and rely on a robotic surgeon to conduct the physical operation. The end result is a more accurate, highly reproducible and tightly controlled outcome. The robotic laser performs to the same specifications day in and day out and can work tirelessly for hours on end. With the availability of suitable operators, laser cataract surgery can be performed on a continuous schedule.
Can laser cataract surgery be performed robotically now? Yes, it can, but the cost is restrictive. FLAC is nine times more expensive than conventional cataract surgery.
New technology is always more expensive than conventional alternatives, and the cost of femtolaser technologies will surely decrease as usage increases. Usage will increase because surgeons with average skills, or even technicians, will be able to operate the equipment. Surgical centres will reduce labour resource expenses by negating the need to hire the most highly skilled surgeons.
All indications are that robotic FLAC surgery for cataract removal will become the predominant treatment option in the near future. It is already technically possible, and industry specialists expect it to become increasingly profitable for surgery centres and yet more affordable for middle class patients as the practice spreads.
About the Author
Les writes about eye treatment for Personal Eyes where you can find out more about eye procedures to suit your lifestyle.