Laser-assisted cataract surgery is becoming more widely used, and the precision of custom laser cataract surgery adds a new dimension to obtaining the best possible vision post-operatively. While the cataract laser can enhance the outcome in many patients, it is not required for a good result, and some eyes may not benefit or tolerate this laser therapy. Your doctor will review with you the options for laser. As a separate technology, a measuring device called “ORA” can be used during surgery to help confirm that the best lens implant power is used; the ORA gives the doctor another reading on how the eye focuses after cataract removal and often allows some “fine tuning” of IOL power.
Lasers used in cataract surgery (such as LenSx) have been used for many years, and create a tightly controlled sequence of tiny energy pulses that help to make precise incisions and help to break apart (soften) the cataract. It can also treat mild astigmatism if needed. When surgery is performed, the laser is used first and then the remainder of the procedure is completed using ultrasound. While an option for many patients, most current insurance plans do not cover the use of lasers to assist in cataract surgery.
ORA System (Optiwave Refractive Analysis)
The ORA intraoperative aberrometry system is connected to the operating microscope and provides a real-time analysis of the eye’s focusing ability during surgery. By doing so, the surgeon can confirm the best lens implant to place inside the eye, based on the preoperative plan.
The ORA is especially helpful when there is a question about pre-operative eye measurements and lens implant planning, and especially valuable in cases where patients have had previous refractive surgery such as RK, PRK or LASIK. Previous refractive surgery of the cornea makes selecting the “best” IOL power challenging, and the ORA adds additional useful information in the achievement of that goal.