Cataract Surgery

What is a Cataract?

Do I need cataract surgery?

A cataract occurs when the normally clear lens of the eye becomes opaque, which results in visual distortion. Cataracts often cause a gradual decrease of vision, glare, difficulty with night vision, and reduced colors and contrast. They often result in a disruption of daily activities such as reading and driving, thus reducing quality of life. Cataracts do not improve and can not be treated with medications. The only known remedy is cataract surgery.  You do not have to wait until your cataract reaches any particular stage to have it surgically removed. Cataract surgery should be performed whenever you feel that your vision is impairing your daily activities of living. 

How is cataract surgery done?

Cataract surgery is usually an easy experience for most patients. It is performed while the patient is awake and does not require any shots. Before the procedure, several drops are used to numb your eye and dilate your pupil. You will simply need to lie back, relax and look up into a microscope. You should not experience any pain. A tiny incision is made in the clear cornea and the cataract is quickly sucked out using a small probe. A lens implant is then folded and inserted into the eye through the tiny incision. Typically, no sutures are used. The day after, most people do not feel any discomfort at all and usually full restoration of vision occurs within the first week. Most people find that there is a huge improvement by the very next day. Most can work and drive within a few days of the surgery.

What if I have claustrophobia or anxiety?

People who suffer from claustrophobia may be anxious about being draped during surgery. This is rarely an issue with cataract surgery and there are many modifications that we can do to open up the draping. Furthermore, there is always an anesthesiologist available by your side to help you relax or to calm your nerves. In extremely rare occasions we can even put you under general anesthesia if that becomes necessary (although it almost never does). You should find the experience easy, relaxing and even enjoyable.

Are you going to use a laser? 

cat1No. The jury is still out as to whether or not this is a superior method to the time-tested phacoemulsification method. In this procedure a small probe is placed through the tiny incision in the eye and the cataract is gently “emulsified” ie: broken up into tiny pieces which are then sucked out of the eye by the probe. This usually takes only a few minutes and is not visible by the patient. This is performed through the tiny, self-sealing incision which does not need to be sutured

 Will I get a lens implant?

All patients undergoing cataract surgery will receive a lens implant in their eye to replace the cataract that was removed. This is necessary because, like a camera, the eye would be unable to focus light effectively without a lens. There are many different types of lens implant and they are generally made out of plastic or acrylic. The lens implant that we choose is custom tailored for your eye preoperatively during the measurements that we take prior to the surgery. 

Premium Lens Implants
 
Many patients have heard about Premium Lens Implants which are not covered by  insurance.  Are they worth the hype?  Read on…
 
When a cataract is removed from the eye it needs to be replaced by a lens implant.  In the past these implants could provide clear vision at distance OR near, but not both.  Also, the regular lens implants could not correct visual irregularities such as astigmatism.  The result was that the implants provided good overall vision but patients were usually still quite dependent on glasses.  For patients seeking greater independence from eyeglasses, the regular lens implants are somewhat limited.
 
Premium lens implants were developed to address the need for greater independence from glasses.  They can provide excellent uncorrected vision for distance and/or near vision while correcting astigmatism at the same time.  The vast majority of patients receiving Premium lenses will be far more independent of glasses than they would have been with regular lens implants. 
 
It is important for patients to realize that Premium lens implants represent essentially a customized approach to gain greater independence from glasses.  For patients who do not mind wearing glasses, the regular lens implants remain a good option. 
 
Types of Premium Lens Implants:
-Toric lenses: These implants correct astigmatism in the eye and are designed to provide clear uncorrected vision without glasses usually for far distance only.  They can also be used in a monovision technique to provide far distance vision in one eye and close reading vision in the other.
-Multifocal lenses: These implants correct for far distance AND intermediate/near vision.  Some multifocal lenses can also correct astigmatism at the same time.
 
Any downsides?
Premium lenses are designed to provide excellent uncorrected vision for distance, intermediate and near.  Nothing in life is 100% and premium lenses are no exception. Some patients will still require occasional glasses for night driving or for reading fine print at near.  A small number of patients (5-10%) will complain of glare or halos particularly when driving at night. 
 
So, worth the hype?
Overall 90% of patients who receive premium lens implants express a very high degree of satisfaction with their vision and would choose this option again.  These lenses are not magical, but for those patients excited about independence from glasses, they are the best option available.

Do cataracts grow back?

No, this is a once-in-a-life-time procedure. Cataracts will never return once they are removed. 

Are the results of cataract surgery “guaranteed”?

There is no such thing as “guaranteeing” the results of surgery. Fortunately, the complication rate of cataract surgery is very low. The vast majority of patients will experience great improvement in their vision.  It is very rare but not impossible for vision to be worsened or lost. It should also be noted that the final outcome of cataract surgery depends on the overall health of your eye in general. Patients who have pre-existing conditions such as retinal problems, optic nerve disease or previous trauma may not experience as high a success rate as other patients.


 






This video-rich presentation focuses on cataracts, the history of surgery, and modern implants. It is entertaining and informative.