Most of the time, cataract surgery is done using phacoemulsification ie using a special hollow probe vibrating at ultrasonic frequency (20-40000 times a second) to break the cataract up and remove it through a small 2.2mm corneal incision.
About 5-6 years ago, femtosecond lasers became available in Singapore to assist with cataract surgery. They only 'assist' the surgeon to do certain parts of the procedure eg. making the corneal incision, making the hole in the front of the lens capsule and pre-cutting the cataract. All of these functions are done 'manually' with standard phacoemulsification and have been done this way for many years with no problems except in rare cases, such as those with very weak zonular ligaments. Even with the use of the femtosecond laser, the surgeon still needs the phacoemulsification machine to remove the cataract.
Suffice to say interest in the femtosecond laser seems to have waned recently. Many doctors who were initially enthusiastic are now much less so, for the following reasons:
1. Outcomes (both visual and in terms of complication rate) are no different between femtosecond cases or standard cases.
2. Some studies even show a slightly higher complication rate when femtosecond lasers are used, compared to standard phacoemulsification.
Ref: https://www.ncbi.nlm.nih.gov/pubmed/28007110
3. Longer surgical time when the femtosecond laser is used.
4. Increased surgical cost.(-this would be OK if it led to a better outcome, but it does not; ie the outcome is not worth the increase in cost)
Overall, my feeling is that use of the femtosecond laser is not worthwhile in the vast majority of cataract cases.
In any case, please be reassured that the risk of blindness is far, far less than 1 in 1000 for a person undergoing catract surgery. Cataract surgery nowadays is very much routine day case surgery, with fast visual and surgical recovery and an extremely low risk of complications.
As far as visual outcome is concerned, the choice of lens implant is likely to have a far greater influence on the post-operative visual experience (than whether the femtosecond laser is used), and you and your grandmother should discuss the various options with your doctor.
