Revolutionary new laser offers patients better results
Calgary has just become home to Canada’s fourth Catalys femtosecond laser. This will be the first in Western Canada, with one in Toronto and two more being delivered elsewhere in Eastern Canada. It will also be the first in Canada to be available through the public healthcare system.
Patients have the option to choose between traditional or the new laser surgery.
However, patients will be charged approximately $650 an eye to have the new laser procedure done. This money will go solely to the lease payments of the machine. Once the lease payments are completed the Southern Alberta Eye Centre will own the machine, and they could potentially start doing the procedures without charge to the patients.
Patricia Arkley, 76, decided to try the new laser surgery after her granddaughter researched the traditional surgery online.
“She said, ‘don’t do it Nana. I don’t want you putting a knife in your eye,’” Arkley said.
Since the 1940s the technology used in eye surgery has continued to evolve.
Photo by Colin McHattieRecently, femtosecond lasers have been developed. Dr. Rob Mitchell, of the Southern Alberta Eye Centre where the laser will be housed, said it works by “producing a pulse of energy that is really, really high.”
A femtosecond is one quadrillionth of a second. To put that into perspective that is one millionth of one billionth of a second. The laser shoots individual pulses by the femtosecond; it is so fast that it looks like a continuous cut, Mitchell said.
A big suction cup filled with saline is placed against the eye. This reduces discomfort drastically because the laser isn’t pressed directly against the eye. The laser is shot through the suction cup and saline.
The Catalys femtosecond laser also uses Optical Coherence Tomography. This is a method of mapping out the eyeball, and it works the same way a CT scan works.
“When you have this really potent laser you can’t just go blasting it into the eye,” Mitchell said.
The mapping process is “amazingly precise,” and happens in real time, he added.
“It’s instantaneous and three-dimensional,” he said. The Optical Coherence Tomography works by reflecting off of the cataract and all the different structures of the eye to give an amazing, mapped out picture of the eye.
“It has revolutionized eye care,” Mitchell said.
The femtosecond laser is then controlled by a computer, which is controlled by the tomography machine.
Mitchell said that the benefits to patients are enormous. The procedure is quick, only taking about five minutes and it will also fix any astigmatism or refractive errors the patient might have had.
The laser is also incredibly precise.
“It is accurate to four or five microns,” Mitchell said. To put that into perspective a human cell is five microns across. A human hair is about 100 microns in width.
“We could carve your name into the cataract if you wanted,” Mitchell said.
Another benefit to the patient is it takes the guesswork out of choosing the best surgeon.
“I’m a really good surgeon, and this instrument will be as good or better than I am on my best day, every single time,” Mitchell said. He also said he predicts that this machine will have patients seeing better by the next day.
After her surgery, Patricia Arkley said the procedure was, “Not bad at all.”
Arkley said she saw beautiful colors moving around like a kaleidoscope during the procedure.
David Eggen, an MLA and Health Critic for the NDP said, “Cataract surgery is a necessary medical procedure. It’s covered under Medicare and if it’s approved under Alberta Health Services then there should not be extra billing.”
“If you start charging extra billing for medically necessary procedures then you undermine the integrity of the public health insurance system,” Eggen said.
Mitchell said, “Patients pay for (the new surgery). If they don’t pay for it, then they don’t get it; they get the standard care, but if we didn’t have it, they wouldn’t even have that choice.”
Cataract eye surgery began many years ago. The earliest versions of today’s modern surgeries began in the 1940s. In those days, surgeons cut the eye in half, squeezed it and out came the cataract. The patient was required to stay in a hospital for one week and had to permanently wear thick glasses because their eye no longer had a lens. However, this surgery was only performed on patients who were completely blinded by their cataracts because it was so extreme. After the surgery, the patient wouldn’t be able to see much for about three or four months and there were many complications that could arise.
Beginning in the 1980s a new method was developed called phacoemulsification. This method created a much smaller wound on the eye. After the incision, an ultrasonic probe was held against the cataract to break it up using vibrations. The surgeon then sucked up the broken pieces of cataract using a small suction probe, and inserted a lens into the eye. This method has improved over the years and is still the current standard of care. Patients no longer have to stay in a hospital and will see results within a couple of weeks. However, phacoemulsification can still have complications. Sometimes the cataract can shatter and fall behind the eye, causing the patient to go blind.