By Pippa Wysong

MONTREAL - Cataracts can now be removed through a tiny 1.5-mm incision with the use of a phaco laser.

This type of laser is already being used in Europe, but a Montreal doctor who has been testing the device for use in North America is happy with the results.

Normally, the incisions required to remove lenses in the procedure need to be 3 mm in length. This newer technology allows for a smaller incision, said Dr. Sam Fanous, director of the Montreal Eye Institute.

The only problem is, "you have to make a 2.5-mm incision so you can insert the new lens," he said.

The problem will be overcome in the near future when more foldable lenses are introduced.

The practise now is to use ultrasound to fragment hardened lenses. The fragments are then aspirated through a 3-mm incision on the edge of the cornea.

The phaco laser uses less energy, and is placed closer to the lens to fragment it. "There is no heat, so there is no chance of burning the cornea," Dr. Fanous said. The bits are aspirated out through a catheter.

The procedure takes about the same amount of time as ultrasound, lasting 15 to 20 minutes.

The downside of the technology is its cost. At $200,000 for the laser device, most ophthalmologists won't be able to afford to buy one for their offices.

"It won't be available soon in public hospitals," said Dr. Fanous, who left the medicare system two years ago to work in a private clinic.