April 27, 2018
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Bangor eye center among first in nation to offer new cataract surgery

By Jackie Farwell, BDN Staff

BANGOR, Maine — A Bangor eye center is among the first in the country to offer a cutting-edge laser surgery to remove cataracts.

Vision Care of Maine began offering the new procedure, which is more precise than traditional cataract surgery and can free patients from wearing glasses, in mid-July, according to Vision Care founder Dr. Craig Young. Since then, eight to 10 patients a week have undergone the laser treatment, which Young said sets a new standard for ridding patients of cataracts, a clouding of the lenses that leads to blurred vision, especially in older people.

“This is absolutely a change in the way surgeries are going to be done from here on out,” he said.

According to Market Scope, a St. Louis, Mo., market research firm specializing in the eye care industry, only about 70 to 80 of the laser machines are in use across the country.

In traditional cataract surgery — one of the most common surgical procedures and well-established as safe and effective — a surgeon uses a blade to manually make an incision in the eye. The cataract, a clumping of proteins, is dissolved and removed, and the cloudy natural lens is replaced with an artificial lens.

The “laser refractive surgery” is safer and reduces the risk of vision problems after surgery, Young explained, though some ophthalmologists remain unconvinced that it’s more safe than conventional cataract surgery.

“The laser is able to do several steps of the cataract operation that I would say are the most delicate steps and the most important steps to getting a good procedure,” he said.

The laser cuts a perfect circle that’s precisely centered on the eye, which means the artificial lens can be implanted in exactly the right place, Young said. That frees eye surgeons to replace the natural lens with a multifocal artificial lens, which allows the patient to see clearly at a variety of distances but must be meticulously positioned to avoid vision problems, he said.

Patients who get multifocal lenses not only lose their cataracts but also can ditch their glasses after the laser procedure. In conventional cataract surgery, patients are commonly implanted with lenses that facilitate near or far vision, but not both.

Jim Tyvoll of Garland underwent the laser surgery a couple of months ago after about a decade of vision problems that started when his right eye was poked with a stick. Tyvoll, 72, who’s otherwise leery of traditional medicine, said he decided to get the procedure after a thorough examination at Vision Care.

His vision improved immediately after the surgery, he said.

“My eyes are just as good or better as when I was a kid,” Tyvoll said.

By age 80, more than half of all Americans either have a cataract or have had cataract surgery, according to the National Institutes of Health.

The laser surgery, which takes about 20 minutes, reduces the risk of damage to the cornea because it requires less power from ultrasound, which is used to soften and break up cataracts, Young said. Plus, it can correct astigmatism, a condition where an irregularly shaped cornea distorts vision, he said.

This type of laser equipment, called a femtosecond laser, has been used in vision correction surgery such as LASIK, but its application for cataracts is brand-new, Young said. The procedure, proven safe and effective in Europe, was performed in the U.S. for the first time in February in Texas, he said.

Dr. David F. Chang, a clinical professor of ophthalmology at the University of California San Francisco and a clinical correspondent for the American Academy of Ophthalmology, said the laser cataract surgery has generated controversy in the field.

“Considering that conventional cataract surgery is already one of the most common and most successful operations performed on the body, investigators so far have not been able to demonstrate any benefits in overall safety when laser assisted surgery is used,” he wrote in an email. “Therefore, patients should not feel in any way shortchanged if their cataract surgery is done with the well established method that has been successfully used in millions of cataract patients annually.”

Some research indicates that the laser surgery has advantages over traditional cataract surgery. It has been approved by the U.S. Food and Drug Administration but the technology is too new for the long-term effects to have been studied yet.

The next closest vision center to Bangor offering the new laser procedure is in Cleveland, according to Young.

The equipment’s steep price tag — roughly half a million dollars — has slowed adoption, as well as the fact that the procedure isn’t covered by Medicare. Patients use private insurance or pay out of pocket, which costs around $1,200 to $3,100 per eye, depending on whether they get multifocal lenses and other factors, Young said.

Young expects more eye surgeons in Maine to offer the laser procedure in coming years.

“This is what makes my life fun,” he said. “To take someone with a visual handicap and be able to light up their world.”

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