Since its inception in 2001,
the National Health Group (NHG)
Eye Institute has continued to
address the increasing demand for
eye care services, and areas of its
research and training.
It incorporates
Tan Tock Seng Hospital’s (TTSH) Department of
Ophthalmology as its flagship clinical unit, and
delivers quality tertiary and primary eye care to
patients in Singapore and the region. With more
than 32 fellowship-trained consultants on-board, the
Institute covers the entire spectrum of ophthalmic
subspecialties, providing comprehensive diagnosis
and advanced treatment for both common and
complex eye diseases.
In part three of the ‘Eye Discoveries’ series by the
NHG Eye Institute, we will be taking a look at the
evolution of cataract surgery, and the benefits
conferred to patients and surgeons, through the
introduction of Femtosecond Laser Assisted Cataract
Surgery (FLACS).
Cataract surgery has evolved rapidly over the years. The
last few years have seen the advent of a new technology
called FLACS, which promises advantages to both the
patient and surgeon.
Femtosecond lasers emit ultra-short pulses of energy
similar to those used in LASIK. The speed and accuracy
of the laser enables it to cut eye tissue with great
consistency and precision. With FLACS, this automated laser can be used to create cornea wounds, open the lens
capsule and fragment the cataract into tiny pieces — steps
traditionally done by the surgeon manually. It can also be
used to reduce astigmatism during cataract surgery. All this
is achieved through high resolution scans of the eye during
the laser process. To complete the surgery,
phacoemulsification is used to remove the cataract
fragments, using ultrasound energy.
Femtosecond laser techniques allow for more precise and
consistent procedures. Although it is not possible to
completely avoid human errors, even the most complex
cases can benefit from FLACS, with reduced risk of surgical
complications. This offers a greater level of safety to both
the patient and surgeon alike. During cataract surgery, a
circular opening on the lens capsule (capsulorrhexis) needs
to be created. The capsulorrhexis created by the laser
is shown to be consistently more circular than a
manually-performed one. In addition, as all corneas
experience some degree of endothelial cell loss after
phacoemulsification during cataract surgery, lower
amounts of ultrasound energy expended in FLACS may
also reduce the risk of corneal endothelium injury. All
these translate to potential improved visual outcomes
for the patient.
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FLACS is an advanced and exciting technology that
offers various advantages. It is going to change the
way we routinely perform cataract surgery. Looks like
the time when a patient says that he had his cataract
‘lasered away’ has finally arrived.
By Dr Yeo Tun Kuan, Consultant, Department of Ophthalmology,
National Healthcare Group Eye Institute, Tan Tock Seng Hospital
