Laser vs. Traditional Cataract Surgery: Do You Really Need the Laser?
Femtosecond vs. Phaco Cataract Surgery Explained
When patients begin researching cataract surgery, a common question arises:
“Is laser cataract surgery better than traditional cataract surgery?”
With modern advances in eye care, the term “laser cataract surgery” has gained attention, but is it really necessary for excellent results? At Constantia Eye Clinic, we believe in offering safe, effective and proven treatment options—so let’s break down the facts about femtosecond laser-assisted cataract surgery (FLACS) versus traditional phacoemulsification.
Understanding the Two Techniques
1. Traditional Cataract Surgery (Phacoemulsification)
This is the gold standard worldwide. It involves:
Making a tiny incision in the cornea using a blade
Creating a circular opening in the lens capsule (capsulorhexis)
Breaking up the cloudy lens using ultrasound (phaco) energy
Inserting a clear artificial lens (intraocular lens or IOL)
It’s a highly refined, time-tested technique that delivers excellent outcomes in experienced hands.
2. Femtosecond Laser-Assisted Cataract Surgery (FLACS)
This newer method uses a femtosecond laser to:
Make the corneal incision
Perform the capsulorhexis
Pre-soften the cataract before ultrasound removal
While this may sound more advanced, the laser replaces only a few manual steps. The core of the surgery—including the cataract removal (by phacoemulsification) and IOL implantation—is exactly the same.
What Does the Research Say?
Multiple peer-reviewed studies have compared femtosecond laser-assisted surgery with conventional phacoemulsification, and here’s what the evidence shows:
Visual Outcomes: No significant difference in long-term post-operative vision between the two techniques
Safety: Complication rates are equally low when performed by experienced surgeons
Cost & Efficiency: FLACS takes longer and adds cost without a clear clinical benefit in most cases
A 2025 meta-analysis by Lee et al. in Scientific Reports concluded that visual acuity and complication rates are similar between FLACS and traditional surgery, with no long-term advantage of laser use for the average patient (PubMed ID: 40731148).
Cost Comparison in South Africa
In South Africa, the cost of femtosecond laser-assisted cataract surgery can be R7,000 to R15,000 more per eye than traditional phacoemulsification. This is largely due to the expensive laser platform and disposables, which are not covered by most medical aids.
Additionally, the total theatre time is longer with FLACS—due to the need to move the patient between the laser suite and the operating microscope, and the added preparation time—potentially increasing scheduling complexity and costs.
Reassurance for Patients: You’re Not Missing Out
Many patients worry they may be “missing out” if they don’t have laser cataract surgery. The truth is:
Choosing traditional phacoemulsification does not compromise your safety or your vision.
International guidelines, including those from the American Academy of Ophthalmology, do not recommend femtosecond laser as superior to standard surgery for most patients.
The Bottom Line
If you’re researching laser cataract surgery vs traditional or wondering about femtosecond vs phaco cataract, here’s what you should know:
In experienced hands, traditional cataract surgery offers the same visual success, high safety, and a smoother, more cost-effective experience—without the added expense of a laser.
Book Your Cataract Consultation Today
Let our expert team at Constantia Eye Clinic help you make the best decision for your eyes. Contact us today to schedule a personalized consultation.
