Is Laser Cataract Surgery BETTER than Manual Cataract Surgery? The final answer.

[@prashantpanda5736]

Salute to u sir for your open and honest statement. At the start of video, I thought it would be another advertisement for going for FLACS, but I was blown away by your honesty and truth. I have also felt the same but couldn't comment on this matter as I do not have femto setup with me. So all my comments doesn't matter as it would seem to be prejudiced. But coming from your mouth, I think it's a great boost for us new surgeons with limited resources to do well in cataract n lens replacement field in ophthalmology!!! Thank you for elevating our confidence with your kind and unbiased videos Regards, Dr Prashant Odisha, India

[@phenomenalfemale524]

This Doctor stands out for all the right reasons. I wish there were more doctors (and dentists) like him who offer transparency. I want the truth from healthcare providers!

[@barbarasquyres9563]

I was under the impression by my ophthalmologist that the laser was far superior to manual because the laser type cost $2000 out of my pocket and the manual type is free this was an eye-opener

[@EyeBalz93]

We looked the at the Femto years ago in our practice and decided it was too expensive (for us and our patients), too time consuming, and provided little, if any, benefit to the patient. Good surgeons don't really need the laser to get good results. Cudos to Dr Wong for stating it like it is. Sadly, many eye surgeons use Femtosecond laser assistance as a way to charge more for the same surgery with little to no benefit to the patient....in my opinion.

[@manuellactaotao5364]

@@EyeBalz93 m

[@smokeandmirrors5656]

Lol

[@dionst.michael1482]

Thank you. Just had the traditional surgery on my first eye. It was covered by OHIP. Doctor talked me into getting a better lense and was able to get it covered through a 'compassionate care' program. I thought I was missing out but you make me feel much better about the future. Will have the second eye repaired in a month. Can't believe how this experience affected my life. You guys don't get near enough credit and praise for giving folks their lives ans careers back. God bless every one of you for what you do. I'm truly grateful. And thanks to my surgeon and his amazing team, Dr Buhrmann-Ottawa General Hospital

[@everythingviral972]

How much of your vision did you get back? I have to get cataract surgery at 34 because of diabetes, which I only got a year ago. I'm only on ODSP. I don't know what type of surgery I'm going to get, still haven't even seen an opthalmologist, just an optometrist who told me I had cataracts I've lost so much of my vision! It's scary. I want the surgery yesterday! The manual one makes me cringe. Apparently you can't feel anything? Any answer would be appreciated.

[@dionst.michael1482]

@@everythingviral972 Oh, my vision is perfect. Better than perfect. If I had to do it again it would have been nice to afford the option of getting the bifocal lense so I could have had completely free of glasses vision but as it is (needing vision correction just for reading or for things close up entirely) my vision turned out amazing. And the extra for the better lenses was well worth it. I noticed how much more brilliant colours appeared to be right off. It was a real novelty at first although that has worn off but my vision itself is great. I’m grateful for it too. A new appreciation for it it.

[@monicahurley2224]

Thank you for sharing your experience ❤

[@steveandtammyb]

Thank y’all for sharing! I’m about to have my cataract surgery in three days and I was worried because I knew that mine was not going to be laser. This video and the comments help allay my fears some.

[@ks5831]

Thank you this video. I just had cataract evaluation. The laser estimate, $7,000. The Standard, $600. Laser is way above my budget. Now, I feel much better not being able to afford the laser. And, as you stated, my priority is being able to see well again.

[@norama3998]

مُريح جدًا الاستماع إلى طبيب فيه أمانة و صدق في كلامه و نصحه للمرضى .. شكرا دكتور على اهتمامك بمرضاك ..

[@TorontoRealEstateAgent]

Thank you very, very much Dr. Wong for putting out such honest, transparent video comparing laser and manual cataract surgery 🙏🏼 I found your video through a reddit forum and your in-depth explanation of both procedures along with their pros and cons has tremendously helped our family in making a decision for my Dad's upcoming cataract surgery. Our family felt very pressured by the ophthalmologist referred to us, to go with a laser procedure as claims were made by the clinic that the laser procedure is safer, quicker, and more accurate method. I wish there were more doctors like yourself who offer transparency backed by the research and experience, rather than the generalized (false?) claims that are likely made in order to drive more income to that clinic for a specific add-on procedure that is not necessarily beneficial to the patient at all. Thank you again Dr. Wong 🙏🏼

[@MrPetrvershinin]

Intraocular lenses become dislodged due to scarring of the lens capsule, trauma, lens ligament atrophy, and laser treatment for secondary cataracts.Secondary cataracts (opacity of the posterior capsule of the lens) sooner or later develop in almost all patients who have undergone lens removal.

[@Anco3496391]

Thank you so much for this video. Presently, I am struggling with blade and bladeless cataract surgery at 74 years of age but your video and the reasons you presented made me decide to have manual surgery. Now, my challege is to identify a surgeon who can perform such surgery. Thanks again.

[@vikassalkade3661]

Thanks!

[@superquig7068]

Excellent, thoughtful analysis and discussion! I had PanOptix lenses installed in December 2020. It was an elective surgery for me (I did not have cataracts - it was a lifestyle choice - for vision improvement). After researching manual versus laser assisted surgeries, I also came to the conclusion that the outcome depended most on the surgeon. To control cost, I elected to go the manual route which saved me $3000. My outcome has been great. That said, I have always wondered if my vision could have been even better had I gone the laser-assisted route. Your excellent discussion has allowed me to move past such thoughts! Thank you.

[@Allan-et5ig]

What would have been "even better?" 20-15?

[@superquig7068]

@@Allan-et5ig Yes. They are often hitting 20-15 with the latest high-end LASIK surgery.

[@KrystalClark-bz1yx]

I am so glad I found this video. My ophthalmologist prefers to use laser surgery, but when I realized that no insurance pays for it, I could not understand having to pay so much money out of pocket for the procedure. After looking at this video and researching further that the outcome is pretty much the same, I did do with the manual procedure using the Limbal Relaxing Incision. I had my procedure this morning. So hopefully everything continues to get better. So far everything seems to be going well.

[@naticeja8849]

How has it gone? My fiancé is debating on doing manual or laser but the cost for Laser is ridiculous

[@davidwayne9982]

THANK YOU for this--- I greatly appreciate the honesty... I thought it would be better too-- but now that I saw this- I'm changing my mind and going with STANDARD surgery... PREMIUM lenses but manual surgery!!! THANK YOU AGAIN... and I checked- my doctor uses one of the TECNIS lenses-- and I think I'll go with the best on of those.. I've talked to several of his patients-- and they all LOVE it...I found NO negatives ANYWHERE... THANK YOU AGAIN. Dr. Reeve is VERY well known in this area--

[@janetphillippe5217]

I can't thank you enough for your honest opinion Doctor. I have catterachs and glaucoma in my left eye. My doctor is treating the glaucoma for two months then I see her again. I have very little vision in my right eye so it is absolutely imperative that this surgery be successful. I have been reading every thing I could find relating to both surgeries but was still confused. Now I know for certain my choice is premium lenses but manual surgery. I am ever so grateful doctor for your honesty and guidance. J.Phillippe

[@willl5970]

TYVM Doc!!!

[@ShannonWongMD]

Thank YOU!🙏

[@billygross1597]

I can honestly respect a cataract surgeon who can give unbiased data reinforced answer , putting it all on the table, by watching numerous videos from you ,my apprehension and anxiety for my pending cataract surgery has gone from high of 100% to a comfortable 1 % now , I thank you for your layman's terms of what to expect,how it's done and what to look for post surgery, I have type 2 diabetes, and suddenly my vision drastically changed within 2-6 months from my last vision test, it was rather odd though ,for years pre diabetic I could only see fine print with the aid of # 4 magnification dollar store reading glasses, then 1 day I could read fine print without glasses! Then I started noticing more & more floaters, some short,some long that I truly thought were spider's webs that were longer,thicker, and would go from 1 side of my eye to the other,all that lasted for 1-2 months the the scary part made its appearance known ,the cloudiness , which is getting thicker daily, I got tested 8 -30-2022 and it was confirmed cataracts, my next appointment with the surgeon is 10 -11-2022 which is frustrating as I caught my spouse cheating after 20 yrs,but Dr's orders not to drive any more till my vision is better, my ex has done an excellent job of separating me from family,friends and any support, I just can't go get groceries,Dr appointment 's,pharmacy ,I can't locate my new checks as I can't see them, so I have to get money orders to pay rent,back rent,& lawyer fees from a permanent injuction, because I couldn't see well enough to paint the exterior of my house and they knew I was struck with heat stroke 2 times within a 2 month period, on an extension ladder is the last place I should be , I'm on a fixed income ,so there nothing to give to some one to incentive them to take me where I need to go,and bring me home, in calif everyone is only concerned with them selves, neighbors won't make eye contact out of fear, so I'm left to blindly fend on my own,after I see the surgeon it could be another 30 days before I could get the surgery, which could realistically be 90 days from diagnosis to surgery, there are 3 facilities here operated by the same company and I was given the earliest appointment, and as my eyes get progressively worse daily , and with no help, you can see my problem, on a previous Dr appointment I found a guy where I live & bought him lunch in exchange for his trouble of taking me to an appointment, he leaves in my car and gets a spare key made, and after I go to sleep ,he comes by unlocks the car ,puts it in neutral and pushes it down the street, so my car was (borrowed )from 8:30 pm till 5:30pm the next day, my car was brought back with the check engine light on,no oil ,no transmission fluid, the passenger window won't roll down ,the drivers window is off the track, so I had to end that situation, I pressed charges , but due to overcrowding he was let loose after 1 day, gotta love our justice system.

[@tqkirk]

Nice analysis. One issue not addressed in your analysis is any comment regarding the differences in the femto laser platforms. I used LensX for several years and had many incomplete rhexis and issues with a few wrap arounds. I've used the Catalys laser for the past 4 years. I have not had any significant issues with the capsulorrhexis quality with the Catalys even in very mature 'catarocks.' We also have the Catalys in a modified clinic room where the doctor in clinic can do the femto so that the surgeon in the OR can remain efficient and OR flow is not impaired.

[@johnroy9654]

I had my premium cataract iols done 5 months ago in Florida. The practice I went to made a HUGE deal about the fact that they used the Femto LASER and used it to sell the procedure on me. They strongly pushed the idea that it was superior to the manual method. HOWEVER... when he did the surgery, I know that he did NOT use the Femto LASER. In fact, I could feel the pressure of the sapphire tipped tool making the incision into my eye. He also said he did PRK to eliminate the astigmatism that I had, which I know was a lie, because I've had PRK done twice in the past, and PRK involves 3 days of agonizing PAIN. There was NO pain after my cataract surgeries. I am not upset that he did not use the Femto LASER, I am upset that he lied to me and sold me on his higher than normal fees based upon the premise that he was using the Femto LASER.

[@regal953]

Was it Florida vision?

[@DeahCurryPhD]

Just have a cataract eval 2 days ago and left totally freaked out when the surgeon recommended the traditional method because, he said, my astigmatism wasn't bad enough to warrant a Catalys procedure. He didn't explain anything about the difference and the idea of having a manual method with a human poking sharp instruments in my eyes sent me into a panic attack. This video has been very helpful in calming me down. Thanks for such a thorough and easy to understand explanation.

[@michaelcoady828]

D0es it hurt

[@StevenGSafran]

Glad to see that you have created this video and I am of course not surprised by your conclusions. This is the direction I always thought that this technology would go once people realized what a ridiculous waste of time, money and resources femtosecond laser for cataract surgery is. The only thing I would disagree on is the role of astigmatism management where I believe that the laser arcuate cornea incisions for astigmatism over time are less safe and more likely to create problems and overcorrection (or no correction) than limbal relaxing incisions placed at the limbus with a blade by a skilled surgeon. I have seen many patients on referral with wild over corrections and irregular astigmatism due to laser arcuate incisions that are causing microdehisence patterns like a cornea laceration would. This is very difficult to fix. You simply do not get this with incisions at the limbus with a blade because of the presence of a circumferential reinforcing ring of collagen there that is not present in clear cornea. We learned this a long time ago and it's why most surgeons abandoned cornea arcuate incisions and RK in the 90s. The laser turned a lot of people back to doing cornea relaxing incisions which we KNEW were not stable, accurate, predictable or safe long term and I am seeing the consequences of that now in my referral practice. Seeing Doctors with great influence with your peers like you have Shannon...who are willing to realize the truth about this technology and share it....even after tremendous personal investment and commitment to the technology is very heartwarming and gratifying. Thank you for your honesty! Respect!

[@ShannonWongMD]

Steve, We agree!

[@jgunther3398]

About a year ago I had surgery the old-fashioned way and it was truly life-changing, from living in a dust storm, to the sharpest vision of my life which almost seemed supernatural. My only complaint is macular edema as a side effect which is about under control now but could have been caught earlier. I was treated by a retinal specialist in a different office. I had the distinct feeling the office that did the surgery actually did not want to catch complications, would prefer to sweep them under the rug, and did not follow up as thoroughly as they could have. Something to avoid trending toward. P.S. Dr. Wong, I lived in Austin 10 yrs ago. It's on my short list of great places to live!

[@shelleydee6217]

Hi Doctor! I had LASIK done some ages ago. I am now diagnosed with cataract on both eyes. Is doing the manual cataract surgery still safe for me? Since this is my first year, is there an eye drop that can prevent it to get worse? If can’t be prevented, how many years do I have to wait to avail such medical treatment such as yours that my insurance will cover? Thank you in advance.

[@StevenGSafran]

@@shelleydee6217 Manual cataract surgery is as safe or safer for cataract surgery and it really doesn't matter if you hae had previous Lasik in this regard. The only real issue with having had previous Lasik is with the accuracy of the intraocular lens calculations which requires some special formulas and measurements with adjustments made for the cornea having had Lasik but that does not really affect the surgery itself. As far as the time frame of needing cataract surgery, that would need to be determined by examination and discussion with you based on the rate that you are getting worse and your desire to see better which is on an individual basis.

[@Maverick-jn9ur]

@@StevenGSafran Hi, my mom is going to go in under femto with lucidis lens tomorrow for her cataract surgery. After reading your comment and watching Dr. Wong's video, we are considering not getting the surgery done. Do you think femto + lucidis is okay? It's being done by a retinal specialist who has great reviews in a hospital in taiwan but I'm not sure if it's the best outcome? I think possibly flying to see you in NJ with manual + tecnis synergy lens would be better? but there's a lot of variables such as arranging travel and stay and it was difficult to get this surgery appointment we have tomorrow (took a long time to setup). So what would your advice be? my mom is almost 80 and is a small frail woman.

[@pradipmohanta9321]

Thank you, it is a bold statement, in favour of manual cataract surgery. My respect to you doctor, Pradip Mohanta

[@ShannonWongMD]

Thank you Pradip!

[@thomasca7606]

@@ShannonWongMD Thank you very much for your video. I also have great respect for you doctor Wong. If I have a white cataract, please advise whether I should go with manual or laser surgery? Thanks so much again, and I really appreciate your help.

[@siliveliosakalia6397]

This is a great video for the people of the world to see especially the people who suffer from eye surgery. Your explanation I think helps both parties in the service of archiving and healings process accuracy. Thanks very much sir. God bless you and your service.

[@mikehenry89]

Will definitely recommend you and your team to friends and family in Austin. Love the videos. Keep up the great work!

[@CheeseMaster524]

Agreed

[@paul8888888888]

As a fellow cataract surgery, I appreciate you having the courage to give an honest opinion which goes against industry and many of your fellow surgeons. The Oath we took was "first do no harm." I feel that the use of laser cataract surgery causes both medical and financial harm to our patients. As I explain to my patients, "Laser-assisted cataract surgery may help bad surgeons have less complications, but in the hands of a good surgeon is completely unnecessary." It serves as a way for some to counter the ever declining insurance reimbursements, which should never drive our decisions in patient care.

[@ShannonWongMD]

Posting this video required no courage actually. I just had to share the evolution of my thought process and what I believe to be in the best interest of all today. "It's always better to know and see the ugly truth than the believe the beautiful lie."

[@YellowSock66]

"laser cataract surgery causes both medical and financial harm" .. what is the medical harm that laser surgery causes ?

[@shivyadav2458]

@@YellowSock66 I am not able to decide as to what I should do.One dr. has advised me that FLACS will be better decision than phaco because previous dr. who did phaco in left eye either did something wrong or it was bad luck but that eye surgery has been managed with multi lense.

[@katec4096]

@@YellowSock66 He said what the problems were at 13:27

[@Allan-et5ig]

@@shivyadav2458 Thank God there was the multi lens to at least, help you manage! Sorry to hear you encountered bad luck or surgical error...

[@karenconstantine334]

Great video… thank you I feel so much better because of you. My insurance only covers the no laser surgery and I was afraid of that

[@hokw8882]

Thank you Dr Wong for your candid and honest discussion on the issue. I will certainly refer my patients to this video the next time someone ask me about "laser cataract surgery". kudos to you!

[@johnhaggerty8023]

Thank you so much. I’ve recently had this done. In my mind it is a miracle, and I can’t thank my surgeon enough. Thank you for your honesty and your search for a better, more efficient and safer way of doing the procedure. John Hudson, Wi

[@HeyitsDee]

Tomorrow I'm going to a new ophthalmologist after being diagnosed with heavy cataracts last August by a sketchy ophthalmologist who scared me to death. Laser surgery isn't covered by health insurance, so I'm glad you aren't recommending it, but because of you, I now have tons of information going forward with this new doctor. Thank you, Dr. Wong.

[@ShannonWongMD]

Use of the femtosecond laser for cataract is safe. In my hands and in my experience, manual surgery is safer.

[@HeyitsDee]

@@ShannonWongMDIf only you were closer to Connecticut: I need a knowledgeable, honest, and calming doctor like you. Thanks again.

[@myobmyob2215]

So manual surgery itself is covered by ins, and the special lens are not, right? Thanks

[@thomasca7606]

@@ShannonWongMD Hello Dr. Wong, please advise which method is better to avoid retina damage? Thank you so much for your help.

[@stronz3669]

Glad you arrived at this conclusion although my question is why did it take you so long to figure this out? I’m a cataract surgeon in the northeast and do similar volumes you mention. Femto assisted cataract surgery never made sense unless the surgeon wasn’t able to learn the technique of capsulorhexis. Most all surgeons eventually master this. The REAL reason femto is adopted is of course financial - surgeons and practices and ASC’s can charge a ton more money. My feeling is that this is not a good enough reason to change a technique. The new technique has to be better in some way than the old for it to be reasonable to change. Femto simply is NOT Better than standard well-performed phacoemulsification in any measurable way. And that is the real reason not to do it. it’s not because of efficiencies or time savings in your ASC. It is because it has been studied in large well-performed trials to determine whether it is equal to, better than, or worse than standard phaco. In all the large studies it has failed to show any benefit. Not safer. Not better vision. Not faster recovery. And that is why it’s isn’t covered by third party payors. It shouldn’t be! Why pay more for something that isnt any better? Health insurers are by no means perfect but if something new is better they will usually cover it eventually because in the long term it will save them money. With femto cataract surgery it’s just not better and hence the non coverage. Your video is refreshing to watch. Just very telling to another in the field that your choice to abandon femto was because you discovered you could be more efficient and do more procedures if you stopped doing femto. Right choice - wrong reason tho, imo. The decision not to do femto is because it is wrong to charge patients for a “premium” procedure when it is in fact no better in any way than the standard procedure. The studies showing this have been around for a long time. Glad you finally got there tho. Now let’s talk about those corneal relaxing incisions……

[@miriamamie8721]

Much appreciated honest assessment of FemtoSecond Laser vs Manual cataract surgery. I look forward to your updates.

[@HanifEyeHospital]

Thanks for such an honest review! I always look forward to your videos!

[@balloney2175]

I just hope you are still practicing/around by the time I needed your expertise.

[@marjorieportee3406]

I just had surgery five days ago, someone at the clenic told me about the double lens to see far and near, the cost of 2.400. 00, I did not see the Optometrist before surgery, no one explain anything to me, but I paid and had it done, seeing far is ok, but seeing near is not good, but I'll give it a week or two, sndgive an update my advice to anyone having eye surgery demand talking with the docter doing the surgery.

[@NeKa..]

Thanks Dr Wong! This was very helpful, as I was here looking to 'justify' the substantial cost difference vs outcomes for manual vs laser-assisted RLE (provided either is conducted by the well-trusted surgeon and team, of course)

[@oseasviewer7108]

This video was very informative - and has given me confidence in the manual procedure of lens extraction - having had LASIK surgery 18 years ago I was very aware of risk on multiple levels. The outcome was relatively positive at the time achieving monovision - nature however determined that reverting back to previous status quo was in order progressively undoing the correction over a period of 5 years.

[@zentex8877]

Very good explanation, well reasoned and clear. I’m sure this will help many patients with their cataract surgery decisions.

[@popogejo7245]

That's it! I'm going with the manuel, never did trust the hi-tech anyway

[@sharonb.robinson3325]

In October of 2022 I had Phacoemulsification cataract surgery (most common)...the right eye was replaced with a basic lens which was covered by my insurance...however the left eye had a stimatism therefore I chose the tumeric lens which was not covered by my insurance...howeve 13:27 r the results were great for me...I do not have to wear glasses and I can read the second from the bottom line on the reading chart...also it was only a 45 minute procedure.

[@officience1]

What toric lenses do you have?

[@CATownsend777]

Thanks for this info. Now if Medicare will only go the distance, covering the cost with the best lenses, i.e. toric lenses, Multi distance lenses, then many Americans could get the best outcomes. Instead, only the upper class can aford the additional costs for the best lenses. Seniors are already short changed on their monthly dividend payments as it is. There is not enough money for the surgeries. Its pathetic what Medicare will not cover.

[@SiggyMe]

This no pun intended an eye opener you have convince me that I could save a lot of money and invest that into a better lens. Now I have to determine how to pick a surgeon that has excellence manual skills. Thanks so much!

[@samipforreds]

Appreciate your honest review.

[@amybradley5821]

What about not having to use all of the drops after surgery? That has made me opt for the laser. Big advantage to me. Hate even the idea of cataract surgery, dreading it sooo much.

[@normaharris5224]

Norma Harris 1day ago AMEN GOD BLESS YOU AND UR TEAM.🙏🙏🙏

[@paddiman772]

Firstly, I really appreciated your presentation. Wish that I had had a better outcome from my cataract surgery. I've only had the R-eye done. And it was a fiasco! The attending Ophthalmologist failed to read the Optometrist's diagnosis of bad astigmatism, and request for a Toric lens. The surgeon did what was mandated by the Ophtha, not the Opto. So a second surgery was scheduled for an exchange. And this time it was a premium Toric lens. This eye had been physically damaged years before by a tennis ball moving at spirited speed and a mean topspin. I scooped it up with my racket only to have it careen into my eye. I was left with internal scaring and about 20% loss of power in an eye that was characterized by a previous doctor as a "ruined Super-eye." Since the surgeries, I've been plagued with what I describe as, "white noise" or a blinding fogginess topped off with huge floaters from shedding vitreous. A YAG treatment has been performed on this eye to alleviate this white noise, but it's still there. I'm going for yet another YAG treatment to poof the floaters somewhat. We'll see. My left eye has a developing cataract. But my current doctor agrees with me to leave it alone until it's absolutely necessary. They had measured the rare 20-15 to near 20-10 for the L-eye. If I lived in Austin area, or anywhere in TX, I'd be asking for an appt. But I think my current surgeon in Knoxville, TN is fairly competent. Says he has done well over 20k cataract surgeries. So when it comes time, I will consider his skills.

[@VanLe-ex8hr]

This is a a real n respectable doctor who is more confident in manual procedure. It's understandable because machine is driven by s/w programs developed programmers based on predefined scenarios/possibilities. How can we be sure all possibilities being catered for, and this is the problem when a new condition is encountered.

[@curtispierre3018]

"Our vision? Perfecting yours!" Love it.

[@dathyr1]

Well if this technology is so much better than standard Cataract surgery, why doesn't our Medicare and Supplements cover the costs of these procedures????????? Well, I guess the last half of the video covers some drawbacks and complications that could occur during laser surgeries. Anything can happen in any surgeries. For me as a Senior, Medicare and my Supplement only covers the standard surgeries and basic Mono Focal lenses. I am getting Cataracts in both eyes done next month, Nov 2024. Hope the outcomes in both eyes are successful and my recover vision goes well. Thanks for the video and honesty about laser surgeries.

[@YakAttack915]

Thank you very much for this video, and your honesty. I have been struggling with this question. Need cataract surgery, and went to two places highly reviewed. One said using laser is best, other said not necessary. Relieved that in your expert opinion, manual is still a great option. One suggested mono focal lens, other said it was up to me, but said mono focal usually gives you better overall vision (with glasses to assist with near and mid level viewing / reading). For those out there, would you still prefer multi focal lens or mono focal? Thank you again for the video, it helped me a lot to understand my options!

[@officialdandaman]

(☞ ͡° ͜ʖ ͡°)☞ I'm in Hawaii and I'll share something with you; my Medicare covers ALL COSTS on manual cataract surgery but NOT laser, and the EXTRA cost for laser per eye is $1,725, was told the Dr gets just over a $1,000 per eye from that so go figure the business side of this. Glad I saw this video because I feel better I'm getting manual for the safeness and the cost. (⌐■-■)🤙

[@sarahplainandtall9877]

I just had eye surgery (cataract removal) and it was a LASER ASSISTED surgery, on July 18th and August 1st, 2023. Medicare covered most of the expenses but NOT the Laser assisted and my out of pocket was $1,500 each eye = $3,000 for both eyes. The reason why, my astigmatism needed to be corrected. Now I have 20/20 vision and reading glasses are as needed. I had an excellent Ophthalmologist who did the Laser Surgery to my eyes. Thanks to him.

[@jonnarobinson7541]

Eye Doctor is calling me at $4000 per eye for laser. This is an Southern California.

[@glendakeglovitz2838]

So glad I watched this..my surgery is August 8th 2o22 Thank you so much..my insurance only covers manual..

[@argon805]

Yes, very helpful, thank you. The last opthalmologist I went to is old school and outrightly said he does manual.

[@jeanne819]

I’m in New York state two hours from the city. In 2020 I was running on a walkway and tripped in a crack- foot got stuck and went flying in air and slammed my head on cement. I have been wearing contact lenses only for near and far vision for many many years since I was in my early 20s and I’m 64. Within two days of the fall my right eye vision deteriorated greatly and I went to the ER to check for internal hemorrhaging which was nonexistent. I went to a neurologist and it was concluded that I have a cataract in the eye and it has been getting progressively worse since the trauma. I’m going to terrible ophthalmologist for testing who doesn’t understand what a trauma induced cataract is and I don’t know where to go. I’m told I can have multifocal lenses but then I will see halos at night time when I’m driving and I drive often and I don’t want to see halos or my other option is not to be able to see up close anymore and I need an outstanding doctor to help me. Do you have any recommendations for me in New York City or is it feasible for me to go to Texas to meet with you about all this as you are so knowledgeable and I trust you.

[@ShannonWongMD]

Two NYC/NJ recommendations: 1) Tal Raviv, MD in NYC or 2) Steve Safran, MD in NJ.

[@jeanne819]

@@ShannonWongMD thanks so much for your help - I am very grateful

[@Allan-et5ig]

Dr. Wong - with the greatest respect: (Firstly - it takes a lot of guts to admit something you've been doing heretofore is not optimal.) Why did it take you many years to change your mind? You mention a peer changed your perspective. Were there not conferences, learned papers, 'galore,' for years, warning of issues relating to laser cataract surgery?

[@CarieWright]

I really appreciate these videos. I actually feel more comfortable with the surgery. However, I have a question. I have severe anxiety do you give anything for that? If I am a type 1 diabetic do you do anything different?

[@thresabeasley1812]

Hello, I chose to not have the laser cataract surgery because of the cost. My left eye everything went well. The right eye was a completely different. Nurses kept putting liquid on my eye for at least 1 hour because surgeon was not in room. I was given nothing to make me feel comfortable. Then the so called anathegest came in later & surgeon had to wait for him. During surgeon did something to give me a feeling like cutting 3 times. I then asked the doctor that was supposed to be giving me something to please help me. He gruffly said I’m giving you all I can. I wasn’t even hooked up to an I V. The surgeon said to me I’m sorry but you will be ok. I was told by a eye doctor years ago that I had dry eyes, to put drops in my eyes. I t never bothered me but after this cataract surgery I have a terrible time with dry eyes. I am 79 , had this done about 3 years ago. I found out that my surgeon moved away shortly after my surgery.

[@dintoons1]

Excellent explanation and comparison! Thank you, doc!! :)

[@sanderscupac7829]

Would you say Lazer with mono lens replacement is ok then???? I had the Femto Lazer cataract surgery mono lens with the ora machine also on my right eye about 1.5 years ago in Las Vegas and am very happy. I am 68 yr. young male. I am looking to have my left eye done.

[@davidwayne9982]

Wish I were close enough to come to you for my surgery- but can't. But- Ive' researched a LOT and Dr. Reeve in tihs area is virtually FAMOUS for being the absolute best anywhere around here.

[@rickkyp4065]

Only one thing matters with cataract surgery.. That is the outcome. Patients are more concerned with outcome than cost. Ideally Surgeons should rank outcome number one leaving speed and cost to trail behind.

[@jhansen389]

With the improved efficiency of manual only lens replacement for premium lenses, have you lowered the prices for custom lenses??

[@sherrynalder1567]

Thank you so much for the information. The IOL/ICL coordinator at my eye center in Utah really pushed the laser. I was given the whole sales pitch which gave me the ick. I had my right eye done a month ago and am still experiencing flickering and blurriness along with the halos. I was told I still have inflammation. I feel like I just threw a couple thousand dollars away for nothing. You can visually see the lens in my eye bouncing around and I can feel it. I am nervous to get my left eye done that is already scheduled. l want the traditional way if they will even do it.

[@DoctorKrad]

I'm in Orange County, CA and I feel the same about the LenSx. I started using it and drifted away. Most of my upgrades are IOL upgrades only. I always explain to my patients that the IOL is where they'll get most value for their money. Granted there are femtosecond lasers that are MUCH better than LenSx at corneal incisions, but still no significant clinical difference in vision in my hands. It's still an obligation to inform each patient that it's available as an option so they can make an informed decision. If one day when I'm old and have a tremor, maybe I'll use femto more ;)

[@yitzchakmordechai]

I tell my patients here in NYC the same thing when they ask for femto. The upgrade is in the lens. I'm not even convinced you are obliged to speak about laser bc it hasn't been proven to be better in any way in terms of outcomes.

[@Allan-et5ig]

Great comment. Hope when you have a tremor you're on a golf course, long retired from surgery, lol.

[@UdayDevgan]

great video Shannon! well done.

[@ShannonWongMD]

Thank you Uday!

[@mrdrejonn]

Dr. Wong im 52 i had cataract surgery in both eyes in 92&95 now i had Lasek surgery distant in my right eye and monovision in my left eye its been three months in both eyes i have blurry problems and i didnt have problems with nearsightedness in my eyes before surgery i wanted just distant Lasek surgery any advice cause im not able to handle not able to see clear.. Thanks!

[@FrugalAggie]

Thank you for a very honest review. I would trust you with my eyes.

[@zack_120]

A very responsible professional 👍👍👍

[@sapiensrex5603]

Lasers are different. The Anglo-Saxon school in relation to cataract surgery knows only the femtosecond laser and the unsuccessful experiments of a certain Dodik (I won’t say that I spelled his last name correctly). Meanwhile, Svyatoslav Fedorov, in cooperation with the military opticians of the USSR, created a working device for laser destruction of the lens substance (Rakot series, wavelength 1.44 nm), the only known alternative to ultrasound. Femtosecond fragmentation of the lens is essentially a kind of mechanical fragmentation. The discussion about which incision is more pathogenetically justified is somewhat different (hello Steven G. Safran)

[@sliderulelover]

Instead of saying bad outcomes were low or rare, you should have given percentages so we could see a quantitative result of LCS and LLR.

[@jimraney4061]

My question is can you have the premium lenses installed with the traditional manual surgery??

[@TheHardhickey]

A lot of people my age I'm 69 on Medicare and it was a year before I could get in and I feel bad for a lot of people that just can't deal with the financial of it

[@T-Mak-s7x]

Thank you very much for your time and sharing your knowledge and calming us down.

[@brutewolf]

As a fellow ophthalmologist, I have to say you’re about six years late arriving at this conclusion. Large swaths of the ophthalmic community were mesmerized by the cash potential of the femtosecond laser. But at our AAO meeting in 2015 it became obvious that this was a canard. Doctors had laid out hundreds of thousands of dollars, expecting a return on investment. By 2015, the data was in, but they continued to charge patients extra for an inferior procedure. Dr. Wong wasn’t alone. Many ophthalmologists, stressed by their massive investments, continued to sell a high tech video game as better patient care. It wasn’t., as this video belatedly admits. So while some were investing in TV commercials and disproven technology, the rest of us were trying to explain to patients that it was a money grab with no real benefit. It’s time for all femtosecond cataract surgeons to not only stop, but to admit that they’ve known it was of no benefit since 2015. They should likewise apologize to the ophthalmologists in their community who were portrayed as technically inferior surgeons,, when in fact we were technically superior, and NOT asking for cash before going to the operating room. Bu the way, I proudly ask patients to pay me for premium IOL’s. It’s wonderful technology with life changing benefits. But I could never stomach the idea of asking for cash for the femtosecond laser. Not once the data was out. These doctors were burdened with extraordinarily expensive equipment that, in the end, offered nothing.

[@amybradley5821]

I only want it so I do not have to do all the drops after. Worth it to me just for that.

[@glendaamante9002]

Thanks for the info regarding the advantage of manual cataract surgery.

[@gerardlunow567]

Great information. Trust a human more than technology for this particular surgery.

[@rockyveniegas9882]

thanks for my decision to go with Manual cataract surgery

[@StephanyinIowa]

Dr. Wong, I am four months post DMARK for a birth injury 73 years ago, and getting ready to have cataract surgery for that eye, which also has 5cyl. Next week is my consult at U of I, and I am wondering about the use of a refractive toric lens such as you have discussed, and whether or not I should expect laser to be best for this reason, or should I depend on the surgeon’s skill at manual? The surgeon is the same one who did my DMARK, and the results astounded both of us. Thank you for your in depth discussions. I am a retired optometric technician and looking forward to this surgery both for the vision, and for the discussion.

[@allenletizia321]

I am in middle trying which way to go. After listening to you I don't think going use laser. Still trying decide lens to use. Ur saying go premium ?

[@nancywong2532]

Thank you very much Dr. Wong

[@6977warrior1]

The femtosecond laser is quicker, more accurate, can be used to help astigmatism (cuts/chops down the out of round edges of the eye), heals quicker and help s cut up very dense and thick cataracts(cuts them in slices like a loaf of bread). There, I said it. But it will cost you about $2000 USD/eye. Part of that fee goes to the doctor and part goes to the surgery center. It is far superior to the bladed method. Oh, and mine came with a free upgraded enhanced monofocal lens and I have 20/20 vision in both eyes now compared to 20/400 (legally blind) in both eyes before the surgery.

[@stronz3669]

Sounds good - unfortunately completely wrong. Not quicker. Not faster healing. Not more accurate (at doing what exactly?). Ineffective at long-term astigmatism reduction. All of these parameters have been studied in large well-designed trials, and found to be no benefit with the laser. O btw still have to use a blade in the femto cases. Other than that you’re spot on.

[@6977warrior1]

@@stronz3669 Sorry. but you're wrong. Do your research ma'am.

[@stronz3669]

@@6977warrior1 ma’am? Interesting assumption. Do my research? Ok: FLACs = femto. PCS is conventional phaco Journal of Cataract & Refractive Surgery 46(10):p 1360-1367, October 2020. | DOI: 10.1097/j.jcrs.0000000000000257 795 patients studies prospectively at 1 yr Conclusions: PCS is not inferior to FLACS regarding vision, patient-reported health, and safety outcomes after 1-year follow-up. A difference was found for binocular CDVA, which, although statistically significant, was not clinically important. FLACS was not cost-effective. AUG 01, 2022 FLACS Versus Phaco: Efficacy, Safety, and Cost By Lynda Seminara Selected by Russell N. Van Gelder, MD, PhD Summary report on the 12 largest studies to date with the following conclusions: The results showed no significant differences between the procedures in mean uncorrected distance VA, mean best-corrected distance VA, or the pro­portion of eyes within .5 or 1 D of the refractive target. Intraoperative and postoperative complications also were comparable: in most studies, there was no dif­ference in endo­thelial cell count at any assessment point through six months post-op. In large random­ized studies con­ducted in France and the United Kingdom, FLACS was more costly than PCS Anything else you’d like to add? Show me the large studies that support anything you claim please.

[@damonmelendez856]

Thank you Dr. Wong, excellent presentation

[@aniketnavalkar5974]

Tecnis Synergy has received FDA approval.

[@mannmeinhaimojmks]

Thank you so much...I am planning for surgery...I was confused which one I should not. I am going for a manual surgery

[@suhaimiseliman8593]

U MODIFIED THE CORNEA TO IMITATE THE FUNCTION OF CONTACT LENSE. GLARE WHEN THE LASER VARIED THE SHAPE, THICKNESS & SURFACE CONDITION OF THE CORNEA😂

[@johnnycarlson3738]

Is the cost for the patient less for cataract surgery without the Lazer assisted ?

[@normanplotkin8105]

I have had astigmatism in both eyes and lazy left eye as a child with one eye weaker than the other. My doctor recommend the laser because he said he could get a better outcome in correcting my astigmatism with a distance toric lense. Is this correct? BTW, my brother is a retired ophthalmologist living in Austin.

[@Lipurl73]

Thank you for your video. It is very helpful in our decision to see which is best.

[@unavitadellamusica]

very informative - thank you for creating this video for our information! Unfortunately, I don't live inthe USA, and anyway, I don't have the funds, even though I will soon need catharact surgery.

[@sudeepbrar6206]

This is such good information, thanks for saying this out loud. Eye surgeon from India

[@ShannonWongMD]

Glad it was helpful!

[@aniketnavalkar5974]

@@ShannonWongMD when will you be able to start implanting synergy?

[@ShannonWongMD]

@@aniketnavalkar5974 Soon...It's FDA approved....best estimate would be July....only an estimate.

[@leeg1995]

Thanks Dr. for the information

[@carmellacarothers0]

Dr Wong ,my friend had a retinal detachment and after the retinal surgery he had a cataract which surgery should he consider having laser or manual surgery to remove the cataract and to replace his natural lens with a premium lens?. He's very concerned about the retina detaching again. THANK YOU DR. WONG

[@ShannonWongMD]

They are both equally safe with regard to retina issues.

[@timshen1456]

Shannon Wong, MD , what is your thought on the premium Len option to repaired retina ? My doc says I should not use multi focus Len aka premium len

[@anilalalwani5141]

Dr. Wong, I have a detached retina and autoimmune disease. Would monofocal or multifocal lens be better for cataract ?

[@thaithaknot]

Just wondering about the clouding of the vision after the lens implant where the back of the capsule is cleared using a laser and the outcome seems to be, by the patients own experience a vast improvement in their vision. Two questions come to mind. Is this the same technology? And also I assume this wouldn't show any improvement in vision by performing this procedure first, before a lens replacement?

[@kaly422000]

This is also my query. Why it is not tried as a trial instead of cataract surgery

[@paigewillow8768]

My cataract surgeons says the same thing S you about laser cataract surgery vs manual with premium lens.

[@shooshenchula692]

Thank you Dr Wong for your expertise and doing this video. Im having surgery on 12/19/2022 on my left eye.

[@martinbecklen6486]

I will need cataract surgery in the next 6-12 months, and am wondering how one goes about finding cataract surgeons who share Dr. Wong's philosophy and conclusions (and experience) and practice in another part of the country.... specifically in Illinois (ie, greater Chicago area). What is the best way to identify such doctors? Thanks you for an interesting and valuable video.

[@HeyitsDee]

After meeting with the second ophthalmologist yesterday, for the second time I'm being told that Panoptix and other premium lens don't give good results and aren't recommended. Do I find a third doctor, or go forward with surgery?

[@ShannonWongMD]

The panoptix works well in eyes with normal structures (retina, cornea, etc). If a person wants to have the least reliance on glasses after cataract or lens replacement surgery, then my choice is the panoptix. No lens is perfect. But the advantages of the panoptix in my experience far outweigh the downsides.

[@joyceprakash5377]

Kaiser tokd me the same thing and talked me out of panoptix lenses.

[@HeyitsDee]

@@joyceprakash5377 Thanks for sharing that!

[@DK-ox7ze]

I didn't understand why femtosecond cataract surgery is better for patients with astigmatism?

[@karenmccabe2167]

I'm supposed to have cataract surgery in the morning, using the Catalyst system. I only have vision in one eye. I'm in my 50s, and super scared of making the wrong choice. I've chosen the lens for seeing at distance rather than up close. Do you feel there is any benefit to doing the laser vs the regular surgery? I've paid 1700 more for it, because the surgeon told me that's what he would choose for himself. What do you think?

[@mrs.v7850]

😊

[@rustyboy46]

Wow excellent analogy of these two quite different procedures. Having cataract surgery myself at the Magruder Eye Clinic In Florida .

[@dennislee3399]

I can not agree you more. Thank you for your sharing.

[@angelwings7930]

When you say “premium lens” what is that ? A brand of replacement lens ? Confusing with knowing what it is.

[@ratherbfishing455]

Please go over seeing a violent tint after cataract surgery. I'm an amateur artist and it still bothers me after two months.

[@zarefmesood3773]

Please answer me with your great advice. I am 91 years old man , I have cataract since 35 years .what is the best to me cataract surgery by doctor 's hand or by laser or not do it at all

[@ShannonWongMD]

Choose your eye surgeon who: 1) has great judgment and 2) great hands/surgical skill. Those two variables determine your surgical outcome.

[@sutonomardi4445]

Dr. Wong, is it true that many patients regretted after implanted the trifocal or multifocal lense IOL ? cause their vision does not smooth ?

[@zappie2016]

Hi Dr. Wong, I'm from Malaysia and will be scheduling for my cataract surgery in June. Saw your vids on PanOptix lens and I was sold but when I asked my doctor, she recommended Fine Vision by B&L instead. Of course I was very disheartened. I have not decided which lens yet as I'm still unsure which one would suit me the best. Your take please Dr. Wong? Thanks in advance.

[@ShannonWongMD]

Finevision lenses are not available in the US. Therefore I have no experience with the Finevision lens.

[@zappie2016]

@@ShannonWongMD Thats unfortunate. Nevertheless, thx Dr. Wong

[@TheRandomDave]

Excellent evidence based information. Thank you for presenting your experience in this video.

[@ShannonWongMD]

My pleasure!

[@summersez1673]

What are "premium" lenses? Also, I just had my first eye surgery and opted for manual surgery. Second eye will be done on Monday. My question is this: I noticed on the paperwork I signed at the time of the first surgery that it said "laser assisted" even though I had requested manual surgery. Does this mean femtosecond laser was used to assist?