Dr. Liu Li-Ching, Department of Ophthalmology
Cataract is the leading cause of treatable blindness worldwide, accounting for 45% of global blindness cases and nearly 39% of moderate to severe visual impairment. According to the World Health Organization (WHO), cataracts are responsible for a significant proportion of vision loss and blindness among the elderly. Globally, more than 2.2 billion people experience vision decline, of whom 1 billion suffer from preventable or yet untreated visual impairment.
With the aging population, the demand for cataract surgery is steadily rising, and treatment approaches continue to evolve with advancements in technology. This article introduces the commonly used methods of cataract surgery. It explains how our hospital’s newly introduced Swiss femtosecond laser cataract system helps patients achieve better visual outcomes and enhanced surgical safety.
Understanding Cataracts and the Two Main Surgical Approaches
Cataracts develop when the natural crystalline lens becomes cloudy due to aging, metabolic changes, or other factors, thereby preventing light from reaching the retina precisely. This leads to symptoms such as blurred vision, glare, or double vision. When daily life is significantly affected, surgery becomes necessary.
Traditional Cataract Surgery (Phacoemulsification):
This method involves creating an incision with a surgical blade, manually tearing open the anterior capsule of the lens, emulsifying the cloudy lens with ultrasound, and implanting an intraocular lens (IOL). Although this procedure is well-established and widely practiced, the stability of capsule tearing and incision-making relies heavily on the surgeon’s skill. It may also pose challenges in cases of mature (white) cataracts or when implanting premium intraocular lenses.
Femtosecond Laser-Assisted Cataract Surgery (FLACS):
With technological advances, femtosecond laser cataract surgery has gained prominence. By replacing several manual steps with laser precision, this approach improves the accuracy and stability of lens fragmentation and IOL implantation. It reduces intraoperative risks and offers clear advantages for patients with complex conditions or atypical eye anatomy.
Introduction of the Swiss Femtosecond Cataract System
To improve surgical precision and safety, our hospital has adopted the Swiss femtosecond laser cataract system. This advanced technology enables personalized treatment planning and provides three core benefits:
1.Safety – Real-time Intraoperative Monitoring for Greater Stability
Equipped with intraoperative Optical Coherence Tomography (OCT), the system provides real-time imaging and monitoring, enabling surgeons to clearly visualize ocular structures and operative depth. This significantly enhances surgical safety and supports optimal visual recovery.
2.Precision – Laser Accuracy Replaces Manual Variability
In traditional surgery, capsule tearing relies on the surgeon’s tactile control. With SMART femtosecond laser technology, low-energy lasers create a perfectly circular capsulotomy, ensuring precise IOL centration and reducing postoperative risks such as lens decentration or astigmatism.
3.Customization – Tailored Parameters for Each Patient
The SMART system utilizes “variable-frequency femtosecond technology,” which automatically adjusts laser frequency and energy based on each patient’s lens density and tissue elasticity. This reduces thermal damage and mechanical stress from ultrasound energy, minimizes complications, and delivers a truly customized treatment.
Case Sharing: Delayed Treatment of a Mature Cataract Increased Surgical Risks
Mr. Chang, a 68-year-old man, noticed that his vision had gradually declined over the past two years, but he assumed it was simply worsening presbyopia. He delayed treatment until nighttime driving became difficult due to severe glare and distorted vision. Upon diagnosis, his right eye cataract had reached a “mature” stage, with the lens hardened and dark brown in color. Removal required higher ultrasound energy, which prolonged surgery and increased the risk of corneal endothelial cell loss.
Had surgery been performed earlier with the femtosecond cataract system, low-energy laser capsulotomy and lens softening could have reduced intraocular energy exposure, minimized damage, and achieved a smoother postoperative recovery.
A Medical Center Standard: Safety, Precision, and Customization for Restoring Youthful Vision
Every cataract patient has unique ocular conditions and visual needs. Femtosecond cataract surgery offers a more precise and customized solution, enhancing both safety and surgical outcomes. This reflects the modern ophthalmology trend toward “customization, low-energy procedures, and high safety.”
We believe that restoring vision is not only about clarity of sight—it is also about regaining independence, social participation, and overall well-being. With continuous innovation in technology and care, cataract treatment is no longer just a means of improving eyesight, but a vital opportunity to enhance quality of life and preserve dignity for the elderly.
Looking ahead, we hope every patient can make informed decisions with confidence and receive personalized, safe, and effective treatment—restoring their vision and reclaiming control over their lives.