The Market of Femtosecond Laser Surgery

Cataract surgery has been transformed from a procedure of Coaching in ancient days (5^th Century BC) to the most modern method, known as Femtosecond Laser-assisted Cataract Surgery (FLACS). The modern Femto technology uses ultra-short optical pulses, as short as one-quadrillionth of a second to perform all the key steps of cataract surgery, thus making the entire procedure more safe, predictable, and precise compared to the Phacoemulsification procedure, in which an ultrasonic device is used. TheFemto laser method is very useful in difficult and challenging cataracts to make it easy for both the surgeon and the patient.

FLACS – Bringing in a Paradigm Shift
The recent advance in IOL technology has changed the outlook of cataract surgery from the days of no intraocular lens implants (IOLs) to the premium foldable IOLs, which can go through an incision as small as 1.4mm, and multifocal IOL technology, where external glasses are not required after surgery. FLACS will certainly bring in a paradigm shift. Phaco machines were not in the affordable range 20 years ago and now many private practitioners in remote areas are using it, so let’s hope the same for FLACS technology.

Small Incision Cataract Surgery
Manual surgery is a good procedure but requires bigger incisions (7 mm), so wound-related complications and slow vision recovery are the challenges.It is cheaper because it is done without the aid of Phacoor Femtomachines. Also, it uses cheaper rigid IOLs, which is enough to perform cataract surgery as it can easily be inserted due to the larger wound that is used in the manual procedure.

Compared to rigid IOLs, modern foldable lens implants are more expensive; however, they can correct astigmatism, a cylindrical-power error caused due to incisions made in the cornea during the surgery or present naturally in some patients. The cataract patients undergoing a manual procedure might have to wear thick glasses or contact lenses post-surgery. But thankfully, modern intraocular lenses like tori Chave been developed to more predictably correct astigmatism during cataract surgery, giving patients an enhanced spectacle-free vision in a single cataract procedure.

Government Initiatives against Cataract
The National Programme for Control of Blindness (NPCB) has been trying to help with cataract surgeries for the poor in the government hospitals. But their initiatives could not be at par with the private hospitals because of the price of modern intraocular lenses. The central government is planning to provide free cataract surgery to an estimated 786 lakh people in an effort to make India cataract-free by 2020. This is an effort to counter the loss in the economy the country suffers every year due to cataract blindness in adults. According to NCPB, cataract remains the major cause of blindness (62.6%) among adults in India. According to another study done in 2010, an estimated 33.4% of blindness caused across the world was due to cataracts. They also state that one in three is blinded by cataracts and one in six is visually impaired due to cataracts.

Since a majority of the patients can regain vision with surgery, the Central Government of India is taking measures to eradicate blindness caused by cataracts by providing the surgery free of cost to the affected underprivileged. Various Government organisations and NGOs are also conducting awareness programs and periodic free checking of cataracts in the rural areas where there is a need. With changing lifestyles, one can’t wait too long as decreased vision can affect daily routine, but many people still believe cataract surgery should be done when it is fully ripened. In the past, the lens could not be extracted safely from the eye unless it was at a relatively advanced stage of development or maturity. With modern technologies, though, the lens can be removed from the eye at any stage of development.

This article has been authored by Dr Sreelakshmi Nimmagadda