A laser that vaporises cataracts in a fraction of a second is set to revolutionise treatment of an eye condition that affects more than half of Britons over 65.
Traditional treatment involves surgically removing the cloudy lens and replacing it with an artificial implant. The technique is called phacoemulsification, during which a surgeon makes a small incision in the surface at the front of the eye with a blade and also an opening into the lens, before the cataract is broken up using high-frequency ultrasound.
The tiny pieces are then removed from the eye through a fine tube, before an artificial lens is inserted. On the NHS alone, more than 300,000 cataract operations are performed every year.
The new procedure uses a computer-guided ‘femtosecond’ laser to dissolve cataracts in the eye with a remarkable level of precision and accuracy. A femtosecond is a quadrillionth, or one millionth of one billionth, of a second – and this is the speed at which the laser pulses.
Surgery is completely bladeless and the equipment incorporates a machine called an optical coherence tomographer (OCT), which is used to create a detailed three-dimensional image of the inside of the eye, meaning the surgeon can plan, customise and perform the entire procedure to an unparalleled level of accuracy.
Controlled by a computer, the laser then fragments the cataract while also automatically creating an opening into the eye, which can be programmed to a precise shape, and makes an incision in the lens, through which the dissolved cataract is then removed in the same way as in phacoemulsification.
After this, lens implantation is carried out in the same way as in the traditional operation. The whole procedure takes just a few minutes, compared with about half an hour with the traditional method.
Larry Benjamin, consultant ophthalmologist at Stoke Mandeville hospital and a spokesman for the Royal College of Ophthalmologists, says: ‘The femtosecond laser is very good for accurate cutting of tissue, whereas traditionally this is done with a knife – it brings a level of accuracy that wasn’t there before. The breaking up of the cataract is also more accurately done, as there can be complications with that part of the traditional operation, which uses an ultrasonic probe to do this.
‘One of the main complications is that you can damage the back of the lens with the probe: this happens in one to two per cent of cases. But using the laser would hopefully reduce this risk.’
Consultant ophthalmic surgeon Bobby Qureshi, who works at the private London Eye Hospital, carried out the first femtosecond laser cataract surgery in the UK and is currently the only surgeon in the country offering the procedure to his patients. However, six more machines are coming to Britain this month, and the treatment should become standard in private practice within a few years.
Mr Qureshi says: ‘This is a huge increase in safety with far lower risk of complications during surgery or after, such as infection. The incision is perfectly crafted and seals closed like a jigsaw, so is very unlikely to leak after surgery and can potentially be even less than a millimetre. Also, as it is much less invasive, the eye is less bruised or inflamed following surgery and therefore heals much faster.’
Last month, Suzanne Rogers, 58, from Wolverhampton, became one of the first people in the UK to undergo the procedure. Suzanne, who works for a company that manages housing for Wolverhampton city council, was diagnosed with cataracts last October.
She says: ‘In recent years, I began to notice my vision deteriorating. I do lots of reading and computer work and started having to sit very close to the screen.’
A cataract is the clouding of the lens, the part of the eye that focuses light on to the retina to form an image, and happens as the lens ages. Light is unable to pass through and vision becomes blurred or cloudy. Left untreated, cataracts can eventually lead to blindness.
Suzanne went to see Mr Qureshi in October after reading a newspaper article about a patient with cataracts who had her vision corrected with a type of artificial lens called the Light Adjustable Lens (LAL). She says: ‘Mr Qureshi confirmed the presence of cataracts and he also told me about the femtosecond laser, as well as other options. In the end, I decided to go for the laser procedure and LAL. I was a little anxious, but Mr Qureshi reassured me completely.’
Suzanne underwent the procedure in her right eye on December 14, followed by her left eye a week later. ‘I needn’t have worried, as I didn’t feel anything,’ she says. ‘Before I knew it, it was all over.’
Suzanne had to wear a protective patch overnight, but when she removed it her vision was already clear. ‘It was incredible,’ she says. ‘And it’s wonderful to be able to see so clearly. I have no regrets and would definitely recommend the procedure.’
Source: Daily Mail