Laser cataract surgery allows for more precise, less complicated procedures
Monday, November 11, 2013
by Giles Bruce, LJWorld
As he got ready for cataract surgery on a recent day, Donald Ogburn just wanted to talk sports.
He said he believes all football players should wear their names on the back of their jerseys, so they're easy to identify. But that purpose is being defeated by the increasing number of players with long hair. "They should have to wear one of these bonnets," the Lawrence man said, pointing to his blue surgical cap.
Photo by Nick Krug
From left, registered nurse Lisa Rector, ophthalmologist Mary Pat Lange and registered nurse Kathy Ramirez monitor Lawrence resident Donald Ogburn during a laser cataract-removal surgery at Lawrence Memorial Hospital
Ogburn's relaxed nature a few minutes before surgery was evidence of how smoothly the procedure went when he had it done on his left eye six weeks earlier. He was also pleased with the results.
"It's like walking in a dimly lit room and someone turns the lights on," said Ogburn, 79.
New procedure offered in Lawrence
Ogburn is one of a growing number of Lawrence-area residents choosing to have their cataracts, a clouding of the lens of the eye that typically affects people as they age, removed by a laser rather the traditional blade. Since Lawrence Eye Care Associates began offering the procedure at Lawrence Memorial Hospital in March, about 75 percent of its patients have chosen to go bladeless (some people are ineligible because their pupils don't dilate well enough).
Eye surgeons say the relatively new technique is more precise and potentially safer than the traditional version.
"This is really the wave of the future for cataract surgery," said Mary Pat Lange, an ophthalmologist at Lawrence Eye Care Associates, who estimates there to be only 150 to 175 laser cataract machines in operation across the country. "We're really fortunate to have this technology here. There are not many cities our size that have one."
The effort to get a LenSx machine in Lawrence began after Lange recognized the new technology's potential for more accurate, less complicated procedures. Her practice then partnered with Lawrence Memorial Hospital, which purchased the machine.
The surgery used to be done by hand, but now the machine measures the exact dimensions of each patient's eye before the laser does the cutting. The improved accuracy of the cut allows the lens implant to be centered properly, which Lange says leaves it more stable over the long run.
The procedure also fixes astigmatism, allowing many patients to ditch their glasses. In addition, patients now need only a topical anesthetic rather than a numbing shot around the eye; complications are down; and the new surgery is quicker.
Scott Hickman, another ophthalmologist at Lawrence Eye Care Associates who does the procedure, credits Lange with spearheading the effort to bring a laser cataract machine to Lawrence.
"It's added years to my life. It's much, much more accurate," he said, before noting a potential downside to the procedure: the fact that Medicare only reimburses for the traditional surgery cost, leaving patients with a bill of a few hundreds dollars. "It's more money. It's more expensive. But I think that's modern day health care: You have to pay more to get better stuff."
Bernice Vervynck of Lawrence underwent laser cataract surgery on her right eye last month and plans to do the same on her other side later this week. "When my right eye healed up, I could see much better out of it than I'd probably have ever been able to in my whole life," said Vervynck, 71, a retired telephone company employee. "The lights were brighter. The colors were beautiful. It was just wonderful."
Vervynck has been wearing glasses for as long as she can remember — "They're the first thing I put on when I get up in the morning and the last thing I take off at night" — but after this week's procedure may be able to go without them for the first time since she was 5 or 6. Either way, she'll at least be able to get back to reading small print and sewing, things her cataracts had begun to prevent her from doing.
A quick, painless procedure
On the recent day at Lawrence Memorial Hospital, Ogburn was given his topical anesthetic and wheeled into surgery. His quips kept coming. "Are you being ornery, Donald?" a nurse asked.
"I want you pancake flat," said Lange. The surgical team, who were all dressed in blue hospital scrubs, lifted up Ogburn's bed to bring him closer to the machine and placed a metal device around his eye to hold it open. His eyeball appeared on a video screen, a black hole surrounded by cloudy blue pigment and thin red veins.
"You're doing a good job," Lange told him. "It's scanning your eye, Don. In just a second, we'll be counting you down."'
The machine scanned the front and back of the cataract and measured the thickness of the astigmatism cuts. "Here we go, Don," Lange said, counting down from 35.
"You're doing great," she said, as the laser started operating faster than the other eyes in the room could see. "Now it's cutting up the cataract. And these are the astigmatism cuts. Here's the main incision, the side incision."
A few seconds later, it was done: a complex procedure done in a matter of minutes.
"You did a wonderful job," Lange said.
Ogburn was wheeled out of the room. Now, he should be able to make out the names on the back of every football player's jersey — as long as their hair doesn't get in the way.