Comparison of morphologic features of clear corneal incisions created with a femtosecond laser or a keratome — PDF, 5.14 MB >
Grewal D. S., Basti S., in: Journal of Cataract Refraktive Surgery April 2014; 40:521-530; Ausg. zur ASCRS und ESCRS
Gentle, minimally invasive operation of cataracts and presbyopia
Cataract surgery is the only option for treatment of cataracts. With around 750,000 procedures annually, cataract surgery is one of the standard operations in Germany. Dr. Breyer is not only a Top-Mediziner [top doctor] of the list of doctors curated by the magazine Focus but is also recognized as a specialist internationally.
In cataract surgery, the clouded natural lens of the eye is removed, and a modern artificial lens is implanted. We are using a minimally invasive surgical technique as a matter of routine and can offer you an individual selection of lenses to enable you to gain more independence from your glasses at your option. The surgery is also able to eliminate presbyopia.
If you have presbyopia but you do not have a cataract yet, we are recommending the placement of premium lenses with multiple focal points, so-called multifocal lenses, or blended vision. This procedure can make you regain your independence from your reading glasses. It is also referred to as refractive lens replacement.
Minimally invasive cataract surgery
According to a survey of the Bundesverband der Deutschen Ophthalmochirurgen [Federal Association of German Ophthalmologic Surgeons] from 2015, it was extrapolated that around 600,000 cataract operations had been performed. The incision length in these surgeries varied between 1.2 and 4 mm; it was 2.5 mm on average.[1][2] Our eye surgeons are performing approx. 4,000 cataract operations annually and place an artificial lens through a minimally invasive incision between 1.5 and 1.8 mm. They were significantly involved in developing this surgical technique since it offers material advantages to patients: There is no suture required, and the incisions do not cause curvature of the cornea (astigmatism) which has a positive influence on the quality of vision after cataract surgery. Dr. Breyer is considered a pioneer in the field of lens surgery internationally and has been using a femtosecond laser in cataract surgery since 2012.
Preliminary examinations
Experience has shown us: The more precise the preliminary examination is, the better the surgical result. We do not only use preliminary examinations to determine whether you are suited for a refractive surgery but also to precisely plan the cataract operation.
The reason is that the result of the operation is influenced to a large part by thorough diagnostics of the eye. These include measuring the anterior and posterior part of the eye with state-of-the-art technology and examining the eye for disease to take no risks. By the way, some operations can also be combined with cataract surgery, such as e.g. surgical treatment of glaucoma.
Important information for contact lens wearers: Please do not wear contact lenses for a period of two weeks before the preliminary examination.
How is cataract surgery performed?
Anesthesia: Select the degree of painlessness you want:
- Twilight sleep after injection
- Twilight sleep and an injection next to the eye (peribulbar anesthesia). In 10 years, no eyeball has been injured by this technique in our practice
- General anesthesia for phobic patients
- Local anesthesia with eye drops for courageous patients
Further preparations on the day of the operation
On the day of the cataract operation, you will receive disinfecting eye drops; hair and body are covered, and the skin around the eye to be operated is disinfected; then, an eye speculum is placed to ensure that the eye remains open.
Gentle cataract surgery with minimally invasive incision technique
Using a surgical microscope, your surgeon makes a tiny incision at the outer edge of the eye to gain access to the natural lens.
The lens is suspended in the lens capsule which is opened with a circular incision (capsulotomy). To remove the eye's natural lens, it is broken up with ultrasound energy, enabling it to be suctioned without problems by means of tiny instruments. This procedure is called phacoemulsification.
Finally, the transparent artificial lens is placed in the empty lens capsule. For this, tiny instruments in which the folded lens is placed are also used. In the capsular sac, the lens unfolds and finds purchase. Depending on the type of lens, the surgeon aligns the lens precisely to provide optimum quality of vision.
Outpatient cataract surgery takes 20 minutes at most. If additional risks are present, we would perform the cataract surgery on an inpatient basis. You can find additional specialist literature references on this topic on this page below.
Specialist in this field
Choosing your surgeon is a material factor for your surgical result. Dr. Breyer is considered a pioneer and specialist for cataract and refractive surgery internationally and has been included in the Top-Mediziner list of doctors curated by the magazine Focus since 2013. He has contributed to developing the minimally invasive surgical technique for cataract surgery and has been using a femtosecond laser at the patient's option for cataract surgery since 2012. Furthermore, the selection of premium lenses is also one of his fields of expertise. In 2015, he developed blended vision according to the Düsseldorf formula and was awarded a prize in the "innovation" category of the Congress of European Eye Surgeons for it.
Your cataract specialist Prof. Dr. Kaymak
Prof. Dr. Kaymak is our leading surgeon for retina, macula and vitreous body surgery and head of our Macula Retina Myopia Center. His areas of expertise also include cataract surgery and the treatment of diabetes-related eye diseases. To make an appointment for a cataract operation, simply call our hotline. We also offer same-day appointments.
Cataract surgery with the new femtosecond laser LENSAR ALLY
Since May 2012, we have been performing cataract surgery with a femtosecond laser at the patient's option. Please read more about this in the chapter on laser lens replacement. We are particularly proud to be able to offer you the latest generation, the LENSAR ALLY, from August 2024 – as the first in Europe! The use of the femtosecond laser provides you with an additional feeling of security and enables an even more precise alignment of the artificial lens in the eye. This is of particular importance if you choose a premium lens. We will be happy to advise you on the type of lens best suitable for you. Do you want to know more about artificial lenses implanted in cataract surgery? Then please continue reading in the chapter on multifocal lenses. In it, you can also find all information about our concept for individual lens selection, 'MI-LENS'.
Further literature
Effectiveness and safetey of femtosecond laser-assisted lens fragmentation and anterior capsulotomy versus the manual tecnique in cataract surgery
Reddy K. S., Kandulla J, Auffarth G, Journal of Cataract Refraktive Surgery 2013; 39:1297-1306, Ausg. zur ASCRS und ESCRS
Geschichte und neueste Entwicklungen des LenSx Lasers — PDF, 504.51 kB >
Knorz M.C., Lerche R-C, Breyer D., Kohnen T., Ophthalmo-Chirurgie 25, (Suppl. 3), 1-6, Juli 2013
Der Femtosekundenlaser in der Kataraktchirurgie. Erfahrungen eines "Anwenders der ersten Stunde" — PDF, 130.51 kB >
Breyer D., Ophthalmo-Chirurgie, 25, April 2013, 71-74
New Generation of Femtosecond Lasers Emerges — PDF, 280.12 kB >
Straub L, Cataract and Refraktive Surgery Today, Europe 4/2010: 43-53
The Origins of Laser Cataract Surgery — PDF, 71.95 kB >
Daily S, Cataract and Refraktive Surgery Today, Europe 3/2011: 92-94
Femtosecond laser capsulotomy — PDF, 459.42 kB >
Neil J. Friedman, MD, Daniel V. Palanker, PhD, Georg Schuele, PhD, Dan Andersen, MS, George Marcellino, PhD, Barry S. Seibel, MD, Juan Batlle, MD, Rafael Feliz, MD, Jonathan H. Talamo, MD, Mark S. Blumenkranz, MD, William W. Culbertson, MD, Cataract and Refraktive Surgery Today, Europe 2011, Vol. 37:1189–1198 Q 2011 ASCRS and ESCRS
Surgeon experiences good results with LenSx Laser over the past year — PDF, 1.56 MB >
EyeWorld, 2011 ASCRS; ASOA San Diego Show Daily Supplement, 1-3
Trends and Breakthroughs in Cataract and Refraktive Surgery — PDF, 379.34 kB >
LenSx Laser System, Knorz M. C., Cummings A. B., Cataract and Refraktive Surgery Today Europe, December 2012: 50
Internal Aberrations and Optical Quality after Femtosecond Laser Anterior Capsulotomy in Cataract Surgery
Miháltz K, Knorz C, Alió J L, Takács A, Kránitz K, Kovács I, Nagy Z Z, Journal of Refraktive Surgery, Vol. 27, No. 10, 2011, 711-716
Femtosecond Laser Capsulotomy and Manual Continuous Curvilinear Capsulorrhexis in Parameters and Their Effects on Intraocular Lens Centration
Kránitz K, Knorz M C, Takács A, Kránitz K, Kovács I, Miháltz K, Nagy Z Z, Journal of Refraktive Surgery, Vol. 27, No. 8, 2011, 558-563
Femtosecond Laser-Assisted Cataract Surgery with Integrated Optical Coherence Tomography
D. V. Palanker, M. S. Blumenkranz, D. Andersen, M. Wiltberger, G. Marcellino, P. Gooding, D. Angeley, G. Schuele, B. Woodley, M. Simoneau, N. J. Friedman, B. Seibel, J. Batlle, R. Feliz, J. Talamo, W. Culbertson, Sci. Transl. Med. 2, 2010
Effect of Femtosecond Laser Cataract Surgery on the Macula
Ecsedy M, Miháltz K, Kovács I, Takács A, Filkorn T, Nagy Z Z, Journal of Refractive Surgery, Vol.27, No. 10, 2011, 717-722
