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Laser Cataract Surgery

It is a well-known fact that modern cataract surgery is extremely safe and successful. Until very recently, all incisions performed during cataract surgery were made utilizing ultra-sharp knife blades composed of either medical grade stainless steel or sharpened diamond blades. In modern cataract surgery, actual removal of the cloudy cataract is accomplished using a small ultrasonic (sound wave) probe placed into the eye through the main incision. Then the cataract material is emulsified into fine pieces and vacuumed out of the eye. This procedure incorporating the use of the ultrasonic probe is known as Phacoemulsification (phaco•emul•si•fi•ca•tion).

A modified form of cataract surgery envisioned using a laser to perform all aspects of cataract surgery. First, this procedure would use laser energy to make incisions on the outside and then inside the eye. Then the laser probe would be placed inside the eye through these incisions and used to vaporize the cataract material, using suction to remove the fine particles out of the eye. This latter removal of cataract material using the laser probe never became surgically viable. Phacoemulsification(ultrasound probe) is currently the way cataracts are removed from the eye, whether or not a laser is used. Laser cataract surgery only uses the laser to make the opening in the shell of the cataract, known as the capsulotomy. The capsulotomy can easily be performed manually by the surgeon prior to ultrasonic removal of the cataract without use of the laser.

Studies comparing manual versus laser assisted cataract surgery reveal safe, reproducible procedures with low complication rates and no difference in patient outcomes including their final visual result. Moreover, the manual method takes less time to remove cataracts since the patient does not have to be moved from the laser apparatus to the ultrasound machine. The other significant difference between the two procedures is that due to the high cost of the laser machine (approximately 1/2 million dollars versus 40-60,000 dollars for ultrasonic machines), laser cataract surgeons charge an extra fee of up to 2 thousand dollars for each eye over the cost of what medical insurance pays. 


The great majority of cataract procedures today are still performed by the manual ultrasonic method. Even among surgeons who have access to both laser and ultrasonic systems to remove cataracts, the strictly manual method is by far the most commonly performed procedure.

Laser cataract surgery in comparison to manual ultrasonic cataract removal is still in its infancy and only time will tell if it proves to be an enhancement over the time tested manual method that is employed in the vast majority of cataract procedures done today.


For the aforementioned reasons, Dr. Goldberg provides high quality, low cost modern cataract procedures to his patients by utilizing the most advanced ultrasonic cataract surgery system available. It is apparent that the manual ultrasonic method provides overall superior cataract surgery results even when compared to computer assisted laser cataract surgery.

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