Laser cataract & refractive lens exchange surgery


By Dr. Jean Keamy

The FDA recently approved the use of the femtosecond laser for performing some steps in cataract surgery and refractive lens exchange (removal of a clear lens). It can also be used to make incisions on the cornea to reduce astigmatism.

keamy_hsThe femtosecond laser provides many benefits during cataract surgery or refractive lens exchange. During traditional cataract surgery, the surgeon manually makes incisions into the cornea. The surgeon uses an instrument to manually make a capsulotomy (a round incision in the anterior capsule of the lens), then removes the lens with ultrasound power with a phacoemulsification hand piece and places an artificial lens inside the eye.

The benefit of the laser is in how precise the cornea incisions can be placed. It also helps make a completely round 360-degree capsulotomy at a designated size. How round the capsulotomy is can affect the artificial lens position and refractive outcome. The rounder it is, the better and more predictable the outcome. Lastly, it can also help reduce astigmatism with precise arcuate incisions on the cornea. Additionally, the laser can pre-soften the lens. This enables the surgeon to use less ultrasound power during the removal of the lens. Using less energy during phacoemulsification is desirable to prevent cornea damage.

There are a few disadvantages of laser cataract surgery. It does take longer than traditional cataract surgery. The first step is to have the laser make all its incisions and pre- soften the lens in one location. Then the patient is brought to the operating suite for the lens removal and intraocular lens implantation. There are also additional costs for using the laser and specific risks with using the laser that your surgeon will review prior to surgery.

It is an exciting time to have cataract or refractive lens exchange. Ophthalmology technology continues to advance to improve safety and improved outcomes.

Dr. Jean Keamy is a board certified ophthalmologist. She owns Keamy Eye & Laser Centre on 24 Lyman St. in Westborough and can be reached at 508-836-8733. Learn more at or Visit to read additional articles by Dr. Keamy.