Is laser-assisted cataract surgery worth the extra money?

As a cataract and lens implant surgeon with over 30 years' experience, I would say "no." We had a femtosecond laser for doing FLACS (femto laser assisted cataract surgery) and stopped using it or recommending it to patients. We found there were no (zero) benefits over phacoemulsification/IOL surgery either in terms of visual outcome or complications. It was more uncomfortable for the patients. The use of the laser did not replace or improve any part of the procedure -it just added another expensive and time-consuming step.

I suspect a major driving force in the use of FLACS is the very low (and dropping) reimbursement from insurance companies (including Medicare). Using a laser in addition allows doctors to escape such unreasonable price controls by charging more out-of-pocket for cataract surgery.

The place to derive value from spending that extra money out-of-pocket, however, should be in opting for more advanced technology lens implants, not in using a laser.

_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic