The opening in the capsule can be controlled by the laser down to a tenth of a millimeter. The laser consistently generates an opening of the desired diameter and a shape that is difficult to reproduce manually. An experienced laser surgeon will make a fully accurate opening. Sometimes the shape may be eccentric or oval.

A more circular, central and precise opening is best when implanting an artificial lens. When using the Restor and Tecnis brands, the openings are usually a tad smaller than for Crystalens.

Laser surgery for cataracts is equally helpful in wound management. A precise opening will allow entry and exit of instruments and insertion of the implant without undue stress on the wound. This prevents wound leakage at the end of the procedure and therefore faster healing.

Splitting of the lens by laser is done without any stress on the capsular bag or the zonular support system. Energy from the laser is delivered from the bottom towards the top, which allows gas generated by conversion of the lens material into plasma to escape, as well as allow the subsequent beam to work without interference from gas bubbles.

Sound energy, a commonly used procedure, can cause inflammation and affect the functioning of the cornea.

In dense cataracts, the bottom is difficult to perceive so the capsule can be accidentally ruptured. Real-time display with the ability to be precise and avoid the bottom of the bag becomes an advantage when using the laser for cataract procedures. Breaking apart a hard, afflicted lens can be time-consuming with traditional sound wave technology. Lasers decrease the time and energy required to accomplish the same task.

Further progress in laser technology is coming. One day maybe even robots will be able to do safe and effective cataract surgeries. For now, we must still rely upon the skilled hands of human surgeons.

For more information about laser cataract surgery, visit www.piineye.com or contact the Khanna Institute at (805) 230-2126.