New advances in cataract surgery


By Dr. Steven A. Nielsen

It’s a fact — as we age, so do our eyes. Most people over 40 will develop cataracts over time, and most will seek some type of procedure to restore their clarity of vision.

Luckily, cataract surgery is the most common surgical outpatient procedure in the United States. Even better, advancements in technology have led to the development of all-laser cataract surgery. Both traditional and all-laser cataract procedures are effective ways to restore crystal clear vision. And both offer a number of lens replacement options, enabling the patient to choose a lens that will best suit their lifestyle and budget. Here is a brief synopsis of both traditional and all-laser cataract surgeries.

The Nielsen Eye CenterMany patients have often assumed that cataract surgery involves the use of a laser. This is entirely understandable, as patients are aware of the exacting precision offered by surgical techniques using a laser. However, traditional cataract surgery requires the manual use of surgical instruments. In traditional cataract surgery, the surgeon uses a blade to make a microscopic incision, or access point, to allow access to the cloudy lens causing blurred and distorted vision. The surgeon then carefully breaks up the affected lens using high-energy sound waves, and removes it. Next, a new lens is inserted. The surgeon uses measurements taken a few days before the procedure to align the new lens (called an IOL, or intra-ocular lens) in the eye.

Recently, cataract surgery received a major advancement with the approval and introduction of a bladeless, or all-laser, procedure. Unlike traditional cataract surgery, the surgeon uses a laser to create the access incision. The laser is also used to break up the affected lens, using less energy and optimizing reproducibility. In other words, the surgeon is able to make the same exact incision each time. The laser method also reduces post-operative inflammation.

Another advantage of all-laser cataract surgery is that it provides the surgeon with real-time, three-dimensional imaging of the patient’s eye, allowing for true customization of the lens replacement procedure. These exacting specifications are not attainable with traditional cataract surgery. This procedure also enables the surgeon to improve astigmatism with precise corneal incisions.

As with any corrective procedure, it is important to schedule time with your ophthalmologist to have your questions answered and your concerns addressed. He or she will be able to assist you in deciding which type of cataract procedure is best for you.

Dr. Steven A. Nielsen is the chief ophthalmologist at The Nielsen Eye Center. To schedule a consultation or examination, call 617-401-8542 daily between 8 a.m. and 4 p.m. or email Archives of articles from previous issues can be read at