Which is the most common cataract surgery in Singapore between femtosecond laser versus phacoemulsification cataract surgery, and why?

Between the two methods, the most common cataract surgery remains the standard phacoemulsification cataract surgery. This is because after the advent of femtosecond laser assisted cataract surgery, many studies have been performed to show that there is no improvement of visual outcome or success rate with the use of femtosecond laser.

Hence, given its higher cost to the patient and no added benefit to the patient’s visual outcome, most surgeons choose to use phacoemulsification and only opt for femtosecond laser if patient’s eye condition truly requires it.

Phacoemulsifiation is the commoner of the 2. Femtosecond cataract surgery has been available for about 5 years now and remains relatively less popular. The reason is due in large part to the fact that femtosecond cataract surgery has yet to show superiority in post-operative results but yet saddles the patient with significantly higher costs. Femtosecond cataract surgery though is found to be a useful tool by surgeons in certain complicated cases.

Advances in technology now allow for 100% bladeless cataract surgery where a Femtosecond Laser (CATALYS) replaces the human hand to make the cuts into the eye without any sharp knives or blades, all in less than 60 seconds.

It performs many of the important and most challenging steps in cataract surgery which enables the surgeon to remove the cataract more gently by using much less energy and surgical time inside the eye, thus enabling faster post-op visual recovery for patients.

The biggest advantage of Bladeless Femtosecond (FS) Laser Cataract Surgery is that it allows perfect centration of the intraocular lens implant (IOL) to the centre of the visual axis. 3D optical coherence tomography scans and laser precision create perfectly sized and circular capsule openings for IOLs.

FS laser capsulotomies attain reproducible, uniformly circular and precise diameter compared to manual capsulotomies, improving refractive outcomes of multifocal / EDOF (extended depth of focus ) IOLs and maximising patients’ chances of achieving total spectacle independence.