Risks of Laser Cataract Surgery

Risks of Laser Cataract Surgery

Dr. Gary Foster- Fort Collins & Loveland, CO

Risks of Laser Cataract Surgery with the femtosecond cataract laser

The Risks of Laser Cataract Surgery

Laser cataract surgery using the femtosecond laser offers some safety advantages over traditional cataract surgery due to the detailed digital imaging and precision of the laser.  As with any surgical procedure, however, there are still risks.  This blog outlines some of those important risks or complications following laser cataract surgery for to consider.

Eye Inflammation

Studies have shown that there is less inflammation in the eye after laser cataract removal than with basic eye surgery, but there is still some inflammation.

You will be on two different anti-inflammatory drops to reduce inflammation.

Uncontrolled inflammation can cause swelling in your retina. If swelling develops in your retina, it can distort your vision.  We would need to refer you to a retinal specialist to treat this if it occurs.

Corneal Swelling

Laser cataract surgery is more gentle on the cornea than standard cataract removal techniques on average so corneal damage is less common but can still occur in rare cases.

During your pre-operative evaluation, I’ll be carefully looking for any risk factors which may pre-dispose you to corneal swelling after your surgery.

If swelling develops, it blurs your vision.  Usually it resolves quickly without treatment with a good return of visual clarity.  Other treatment options are available if it persists. I’d prefer to avoid it all together.

Laser Interface Suction

To prevent your eye from moving and to ensure precise results, the “laser interface” physically touches your eye and holds on by creating gentle suction.

It is only in that position for about 40 seconds.  But a strong movement of your head or eye could break the suction.  This would require that the surgery pause while the suction is replaced or in some cases that the case be postponed or converted to standard eye surgery.  The suction is mild, but can cause some redness of your eyes for the first week after eye surgery.

If your eyes don’t open very wide or if the white part of your eye is puffy, it may be difficult to get the laser into the correct position for the surgery.  In this case, the surgery would have to be postponed or done in a standard fashion.

If there is something that would block the path of the laser light, like corneal scars or folds, then the laser would not be able to treat what lay behind the obstacle.  This could create a scenario where that part of the surgery would need to be completed by hand.

Experienced Laser Cataract Surgeon

Laser cataract surgery is technically different than standard traditional eye surgery.  A crucial part of both laser cataract surgery and standard surgery is creating a perfectly round opening, called the capsulorhexis, in the thin outer coating of the cataract.  It is through this opening that the cataract is removed.

One study from Australia showed that surgeons that were just learning femtosecond surgery had more trouble obtaining a perfect capsulorhexis and removing the entire cataract than those with experience so it is recommended that you find an eye surgeon with extensive experience.

We were one of the first in the U.S. to offer the benefits of this technology.  Your eye doctor may have performed a number of basic cataract surgeries, but could be just learning how to do the procedure.  Surgeons have to learn somewhere to gain experience, but they don’t have to learn on you.

Residual Astigmatism

One advantage of this technology is that the femtosecond laser can reshape your cornea while it is helping remove the cataract.  The laser does a very good job of this for most patients, but no method of astigmatism correction is perfect.

You may still retain part of your astigmatism or the direction of our astigmatism could change.  If this occurs you will need to discuss alternative methods of reducing your astigmatism.

Standard Cataract surgery vs Cataract Laser Surgery

There are some risks associated with cataract surgery in general, no matter how it is performed.  These include risks like infection, detached retina and hemorrhage.

A number of tests are performed to help identify the correct power of intraocular lens for your eye.  These measurements are good but not perfect resulting in some amount of target error.

Most are very close to ideal while others are more near or farsighted than they would prefer.  This improves the accuracy of these results, but still falls short of perfection.

The risks of not having laser cataract surgery

Femtosecond cataract surgery for sun and headlight glare

Laser Cataract Surgery for sun and headlight glare

One thing is certain.  If you have a cataract, it will get worse over time.  If you do not feel like your life is affected by your cataracts then waiting until they get worse may be the best decision for you.

Within reason, it doesn’t get harder to remove the cataract if you wait a bit longer.  However, if your cataract is significant, then your blurry vision could put you in harms way.

Consider how it would feel to crest the top of a hill and have the sun hit you in the eyes.  The glare from your cataracts could make it impossible to see the road clearly for a few moments.  If this is happening, then for the sake of the squirrels and small farm animals, please get your cataracts repaired.

Night driving is another activity that often feels less safe with cataracts.

This list is representative of the risks of cataract laser surgery, but it is not comprehensive.  Your eye surgeon will discuss your specific risks with you at your consultation.  If I can help answer any other questions for you, please schedule a time to meet with me or use the contact section of the blog to send me a note.


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