Laser treatment for cataracts arrives in Southwest Florida

— If timing is everything when it comes to one's health, Kay MacPherson has done her eyes right.

The Marco Island resident recently became the first patient in Southwest Florida to undergo cataract surgery with a laser, blade-free procedure.

"It was painless. It takes five minutes," MacPherson, 75, said. "It was more involved for the preliminary tests."

The computer-driven laser surgery was done by Dr. Jonathan Frantz at his Suncoast Surgery Center in Fort Myers. He did her right eye first and her left eye two days later.

The day in between, she had a check-up at his practice, Florida Eye Health, in Naples to make sure all was going well.

Redness in her eyes is the only side-effect but cloudy vision from her cataracts is gone. She also decided to have refractive surgery to correct her vision and be free of glasses.

"I had bifocals," MacPherson said. "I would take them off and put them down and couldn't find them."

Frantz said he is the first cataract surgeon in Southwest Florida to purchase the LenSx laser, which came on the market for commerical use in early 2011. The laser is marketed today by Alcon Laboratories, a Fort Worth-based eye-care company that was acquired by Swiss company Novartis in 2010.

Alcon officials weren't available for comment about how many LenSx systems are in use in the United States.

Other medical technology companies have been coming out with lasers for cataract surgery, including Abbott Medical Optics, which gained FDA approval for its laser a month ago.

About 22 million Americans 40 and older are affected by cataracts, and more than half of Americans 80 and older will have them, according to the American Academy of Ophthalmology. The medical cost for treating cataracts was estimated at $6.8 billion annually in 2008, according to the National Eye Institute. About three million Americans have cataract surgery annually.

Traditional cataract surgery involves an incision and inserting an instrument to use ultrasound waves to soften and break up the natural lens so it can be suctioned out. After the natural lens and cataracts are removed, an artificial lens is implanted

David Albers/Staff 
 Eye surgeon Dr. Jonathan Frantz, left, prepares to perform bladeless laser cataract surgery at the Suncoast Surgery Center on Thursday, May 17, 2012, in Fort Myers.

Photo by DAVID ALBERS, Naples Daily News

David Albers/Staff Eye surgeon Dr. Jonathan Frantz, left, prepares to perform bladeless laser cataract surgery at the Suncoast Surgery Center on Thursday, May 17, 2012, in Fort Myers.

The technological advancement of laser-controlled cataract surgery is tremendous for patients because it delivers safety, precision and better vision, Frantz said.

"Those are the things they want," he said. "Every 20 years, there is a paradigm shift in what we do."

He expects laser cataract surgery to become the norm five to 10 years from now, so he invested $500,000 in the technology today. He's also been performing laser-based LASIK surgery to correct patients' vision for several years.

The downside is that Medicare won't cover use of the laser for cataract surgery because it is considered refractive surgery, so patients pay out-of-pocket.

The fee at his practice ranges from $1,500 per eye to $3,200 per eye with the laser, with the differences based on the lens implant that the patient selects for vision correction.

From his perspective, the laser customizes the incision to the shape of the patient's natural lens, which is key when the implant is put in.

"Ten percent of the time we can do as well as the laser does," he said, referring to traditional cataract surgery when surgeons manually make the incision.

"The rounder it is, the better centered it is," Frantz said. "If the opening is off, the lens implant may tilt or not sit right and that has impact on vision. Laser incisions are perfect."

Another advantage is that the laser softens the natural lens more, which makes it easier to use the ultrasound energy to remove it and the cataracts.

The laser, which gets docked over the eye, takes about 20 seconds to custom map the incision and about 50 seconds to break up the patient's natural lens. From there, the patient goes to the surgical suite for the cataracts to be removed and for the implant.

"Most patients are back to normal activities the day after surgery but vision isn't perfect," Frantz said.

MacPherson, the Marco Island resident, realized about eight months ago that her vision was getting cloudy, making it impossible, and frustrating, to thread the needle in her sewing machine.

She went to Frantz in late April and he showed MacPherson her cataracts and explained the options. He said he was getting the laser soon, so she waited. She had no qualms being the first patient because her husband, Bill MacPherson, had traditional cataract surgery with Frantz a year ago and was pleased.

"I felt so confident that he wouldn't do it if it wasn't best for me," she said. "There was no pain at all."

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