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A new study is under way to compare the effectiveness of two methods in reducing astigmatism during cataract surgery, which can lesson the need for glasses after the procedure.

A new study in the Alkek Eye Center at Baylor College of Medicine is under way to compare the effectiveness of two methods in reducing astigmatism during cataract surgery, which can lesson the need for glasses after the procedure.

Using the femtosecond laser technology, helped developed by Baylor doctors, the study will compare the effectiveness of correcting astigmatism using the penetrating partial thickness incisions in the cornea with the non-penetrating ones.  

Laser technology helps ophthalmologists at Baylor remove cataracts with less energy, more precision and better outcomes in regards to seeing without glasses.

“After cataract surgery, uncorrected corneal astigmatism may increase the patient’s dependence on glasses, but the femtosecond laser can help minimize this astigmatism by performing partial thickness incisions on the cornea,” said Dr. Zaina Al-Mohtaseb, assistant professor of ophthalmology at Baylor.

A cataract is a clouding of the lens in the eye. Cataracts typically grow slowly, causing decreased vision and also glare at night. While cataracts can affect people of all ages, they mostly affect adults over 50 and get worse with age.

Laser technology

The femtosecond laser is the newest in cataract surgery. The laser softens the cataract, which results in less ultrasound energy during the surgery. Lower energy results in less swelling and shorter recovery time after surgery. After the cataracts are broken down by the laser, they are removed. 

“The laser helps us customize our treatment plan and automate the most critical parts of the cataract surgery,” said Al-Mohtaseb.

“It helps us perform certain steps in a precise way so that our prediction of how the patient will see without glasses is more accurate,” said Dr. Sumitra S. Khandelwal, assistant professor of ophthalmology at Baylor.

How it works 

Using a three-dimensional imaging method, the laser takes photographs and measurements of the eye to use in its treatment and helps to:

  • Create the central opening in the capsule – the delicate, thin membrane that surrounds the cataract – with a level of consistency and predictability that is not available with manual techniques.
  • Perform fragmentation of the cataract, dividing it into small, soft pieces.
  • Reduce astigmatism by making incisions far more precisely than can be done by hand or by placing a special astigmatism-correcting lens.

“The ability of the laser to make precise cuts to correct astigmatism has set a new level of accuracy—and comfort,” said Al-Mohtaseb. “Our study will compare the effectiveness of correcting astigmatism using the penetrating partial thickness incisions in the cornea with the non-penetrating ones. We are excited to be involved in further developing this great technology.”

Outpatient procedure

The procedure is done in an outpatient setting. “Patients first have their eyes dilated, then are given medication to help them relax a little,” she said. “The laser part of the procedure takes approximately four minutes or less.”

“This is particularly exciting and beneficial for patients who have complex cataract conditions, such as very dense cataracts, poor support for the cataracts or other eye conditions such as fragile corneas,” said Khandelwal.