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Cataracts
Cataracts are the leading cause of poor vision in adults. Although the formation of cataracts can make activities such as reading and driving difficult, good vision can be safely restored with outpatient cataract surgery. Fortunately, we live in a time where technological advances have made cataract surgery safe and effective, allowing many patients to enjoy the best vision of their lives.
Normal Vision
Our eyes work much like a camera. Light enters our eyes through the cornea, it is then focused onto the retina by lens. The retina then converts the light into electrical impulses which travel through the optic nerve to the brain.
Clear vision depends on this entire chain of events, but seeing clearly depends largely on the clarity of the lens.
What is a Cataract?
A cataract is a clouding of the natural lens inside your eye. Normally, light passes through the clear lens and is focused on the retina; however, cataracts block light preventing clear images from being seen. Cataracts may be the reason sharp objects become blurred, colors become dull, or seeing at night becomes difficult. It may also be why reading is difficult, or why glasses that used to help you are no longer effective.
Cataracts are a result of the aging process, although their progress may be more advanced by injury or certain diseases and medications. As the majority of cataracts are part of the natural aging process, they cannot be prevented. Diet, and lasers are not effective in treating cataract. The best way to treat a cataract is with surgery that removes the old clouded lens and replaces it with a new, clear artificial one.
Cataract Surgery
Cataract removal is one of the safest and most effective surgical procedures performed today. Atlantic Eye Institute’s surgeons have performed thousands of successful cataract operations, and are up to date on the latest technological advances in cataract surgery.
The operation entails making a tiny incision in the eye and inserting an instrument about the size of a pen tip to break up and remove the cloudy lens. This process is called phacoemulsification or “phaco”, and utilizes ultrasound to gently and safely break up, or “emulsify”, the cataract. The small fragments can be safely removed through the tip of the probe, without making a larger incision. After the cloudy lens has been removed, an artificial intra-ocular lens implant or “IOL” is inserted through the same tiny incision and set into its permanent position. In most cases, the incision is so small that it does not even require stitches to close.
What to expect before, during, and after surgery.
Most people are surprised to find out just how easy and pain free cataract surgery is. The procedure itself usually takes 15 to 20 minutes or less, and most patients are able to resume most of their normal activities the following day. Atlantic Eye Institute surgeons perform cataract surgery in an outpatient surgery center, allowing patients to return home shortly after their procedure is finished. Prior to surgery, you will be given a prescription for drops to prevent infection which you will begin taking several days before surgery. Once you arrive the day of surgery, an anesthetic will be given to numb the nerves in or around the eye so your surgery will be comfortable and pain free. After the surgery many patients have improved vision right away; however, it is normal for your sight to improve greatly over the first days or weeks.
Custom Cataract Surgery at Atlantic Eye Institute
Our physicians realize that every patient is different and has unique goals for their vision after cataract surgery. Fortunately, you have encountered cataracts at a time when both surgical procedures and lens implant technology have taken great leaps of progress. Measurement s obtained at your pre-operative consultation allow us to incorporate most or all of your glasses prescription in your lens implant. Micro incision surgical techniques allow for quick healing and vision recovery. These advances allow us to not only treat the cloudy lens, but potentially to give you the best vision of your life!
Astigmatism Correction with Cataract Surgery
Sometimes the surface of the eye, or the cornea, is curved more like a football than a basketball, with both flatter and steeper curves. This common irregularity, called “corneal astigmatism”, causes blurred or distorted vision unless it is corrected using glasses, contacts, or surgical procedures. The standard monofocal lens implants used at Atlantic Eye Institute are the best and most technologically advanced available, but they do not correct for astigmatism. They provide excellent vision after surgery, but for patients with large degrees of astigmatism, glasses may be required after surgery. Patients who desire to have better vision along with freedom from glasses have several options available.
Limbal relaxing incisions, or “LRIs”, can be performed at the time of cataract surgery to reduce post operative astigmatism. Small incisions are made in the steep areas of the cornea to “relax” the cornea and melt away some of your astigmatism. This procedure is generally safe and effective for mild to moderate astigmatism, and can be incorporated in the cataract procedure.
Another option that can be considered is a premium astigmatism correcting lens implant, or a toric IOL. A custom lens is selected based on measurements taken during your evaluation which includes not only your near or far sighted prescription, but also your astigmatic correction. These toric lens implants effectively reduce or eliminate mild to moderate astigmatism.
The most definitive treatment for astigmatic correction after cataract surgery is eximer laser correction. After your cataract surgery is complete, any residual astigmatic error is measured, and is then removed using our Allegretto Wave IQ laser. This procedure, commonly known as LASIK or PRK (Photorefractive keratectomy), is safe and effective for treating moderate to advanced astigmatism.
If you have astigmatism and would like to be free from glasses after your cataract surgery, talk to your surgeon about which option is best for you.
Reading After Cataract Surgery
By the time most patients are diagnosed with cataract, they have already been wearing reading glasses due to presbyopia. Presbyopia is the age related condition that blurs near vision due to the loss of flexibility of the natural lens and surrounding muscles. Modern cataract surgery can allow many patients to read without glasses for the first time in years. Depending on your goals for cataract surgery, there are several options available.
The standard lens implant used in cataract surgery is a monofocal lens, meaning that has one point of focus to give clear vision. If your visual goal is excellent distance vision for tasks such as sports or driving, these implants can give you the best distance vision possible, but reading glasses will be required for close vision. If independence from glasses is important to you, these lenses still can be used effectively with “monovision”. Monovision correction utilizes a lens for your best distance vision in your dominant eye, but close up lens for your non dominant eye for reading vision. Most patients readily adapt to the different lenses and are left with good distance and reading vision.
Recent advances in IOL technology have made improved “multifocal” IOLs an attractive choice for some patients. These premium IOLs are designed to replace cataracts and correct both near and distance vision at the same time in each eye. The Acrysof® Restor® was one of the first premium lenses to achieve a high level of success in giving patients great distance, reading, and intermediate vision. The FDA studies show that 80% of patients with Acrysof® Restor® implants achieved independence from glasses. These lenses can be used to to correct near sightedness, far sightedness, and presbyopia. This technology allows Atlantic Eye Institutes Surgeons to give you a full range of clear vision. Talk with your doctor about whether the Acrysof® Restor® premium IOL is right for you.
Frequently Asked Questions
When should I have cataract surgery?
Everyone begins to develop cataracts by the time they reach their 50s or 60s, but not all cataracts bring down vision. Many people believe that cataracts have to be “ripe” before they can be removed. Advances in cataract surgery’s safety and effectiveness make this procedure available as soon as your cataracts bring down your vision and interfere with your daily activities and quality of life.
What IOL implant is right for me?
No single lens is right for everyone. Only you and your ophthalmologist can decide which implant is the most appropriate for you. Talk with your surgeon about your goals for your vision after surgery.
Can cataracts come back?
Once cataracts are removed they do not return. Occasionally patients notice months or years after their surgery that their vision again becomes cloudy. This condition is known as a secondary cataract, and can be easily and rapidly treated with a laser in the office.
Is cataract surgery covered by insurance?
In most cases standard cataract surgery is covered by insurance. Premium lens implants and astigmatism correction may not be covered by your insurance carriers. Our surgical planning department will go over these details with you.
How safe is cataract surgery?
All surgeries carry some risk. Cataract surgery is among the safest procedures performed today, with an overall success rate of 97% or greater. Your surgeon will provide you with all the risks and benefits of cataract surgery.
Who performs my cataract surgery?
Atlantic Eye Institute’s ophthalmologists who have special advanced training in eye surgery perform our cataract operations.
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