A cataract is a clouding of the eye’s naturally clear lens. Your eye becomes like a window that is frosted or yellowed. Cataracts are a common cause of vision loss, especially as we age, but they are treatable. The only definitive treatment of cataracts is surgery to remove the eye’s cloudy lens and replace it with an artificial clear lens. Cataract surgery can only be performed by an ophthalmologist (Eye M.D.). There are many artificial lens options for people undergoing cataract surgery, some of which provide the chance for significantly less dependence on glasses after cataract surgery. Please view our educational videos for further explanation and illustration of cataracts and cataract surgery.
Cataract surgery has come a long way over the last few decades. In the past patients stayed in the hospital for several days after their surgery and their activities were very restricted for several weeks. Patients often had to wear thick glasses after cataract surgery to see well. Today, cataract surgery is much less invasive and is performed through a tiny incision, which usually requires no stitches. In fact, with the latest laser cataract surgery technology available, no scalpels or blades are needed for the surgery. Surgery is now performed using only minimal anesthesia with numbing eye drops and mild sedation for comfort. Patients usually go home less than 30 min after their surgery.
Thick glasses are no longer needed after surgery. In fact, many patients will only have to wear glasses for close-up activities such as reading. There are even some lenses that give patients the ability to see both far away and up close with minimal or no dependence on glasses. Please see our “Lens Implant Options” page for more information. As for the cataract surgery itself, pictures and videos are worth a thousand words, so please view our educational videos for further explanation and illustration of cataract surgery and the advanced technologies offered by our practice.
Cataract Surgery Overview
Laser Cataract Surgery
Lens Implant Options (ReStor, Toric)
If you are diagnosed with cataracts, it’s not necessarily a bad thing. Modern cataract surgery is an efficient, painless procedure with minimal recovery time, and it provides patients with an opportunity to have much better vision than they’ve had in many years. During your cataract surgery we will replace your cloudy natural lens (cataract) with a clear, artificial lens that remains in your eye for the rest of your life.
There are many options for replacement lenses, and during your visit we will perform sophisticated testing to determine which replacement lenses would work best for you. Factors such as astigmatism (when the surface of your eye is shaped more like a football or spoon than it is round, like a ball), co-existing eye conditions (glaucoma, macular degeneration, lazy eye, etc.) and your hobbies and visual goals are taken into consideration before lens replacement recommendations are made. Below are brief descriptions of the available replacement lens options.
Intraocular Lens (IOL) Implant
Monofocal Intraocular Lens (IOL)
Toric Intraocular Lens (IOL)
Like the standard replacement lens, however, bifocals or reading glasses would most likely be needed for close-up visual activities. Because medical insurance does not fully cover the cost of the toric replacement lens, there is an additional out-of-pocket expense for patients who choose this option. Please watch the accompanying video to learn more about this lens option.
Multifocal Intraocular Lens (IOL)
Conventional lenses (monofocal IOL) do not allow for clear near vision after cataract surgery. Fortunately, a new generation of intraocular lenses called “multifocals” makes it possible to restore your ability to focus on things at varying distances with less dependency on reading glasses or bifocals. Some people even find that they are completely glasses-free at all distances after receiving a multifocal replacement lens. However, a small percentage of people will still find it more comfortable to use glasses for prolonged near or intermediate-distance activities.
After considering all the information gathered during your comprehensive cataract evaluation, we will speak with you to determine whether a multifocal replacement lens is the best option. Because medical insurance does not fully cover the cost of the multifocal replacement lens, there is an additional out-of-pocket expense for patients who choose this option. Please watch the accompanying video to learn more about this lens option.
Advanced Technology for Customized IOL Selection
If your eye is abnormal in shape or you have had prior refractive surgery (LASIK, PRK or RK) our ability to predict the appropriate lens power for clear unaided vision is diminished. In the last few years a new advancement called intraoperative wavefront aberrometry has significantly improved our ability to customize the lens selection to fit a patients eye in these situations. This device uses light to measure the length and shape of your eye in the operating room once the cataract has been removed. This information combined with the measurements obtained at your pre-operative visit will be used to select the appropriate lens power for your individual eye, resulting in better vision without glasses.
Because medical insurance does not fully cover the cost of this technology, there is an additional out-of-pocket expense for patients who choose this option. Please watch the accompanying video to learn more about this technology.
Corneal Relaxing Incisions
Astigmatism affects your ability to see clearly without glasses following cataract surgery. Astigmatism occurs when the eye’s surface (cornea) is shaped more oblong like a football or spoon than it is round like a ball. If corneal astigmatism is not corrected at the time of cataract surgery, prescription glasses will be needed to see for distance, near, and intermediate distance activities. Today there are more options than ever before to correct astigmatism surgically at the time of cataract surgery. There are two basic ways to surgically reduce astigmatism at the time of cataract surgery. The first, the Toric IOL implant, you have learned about in our discussion of the intraocular lens implant options above.
Presbyopia is the inability to focus up close due to a hardening of the eye’s natural lens that prevents it from accommodating, or changing shape to focus for near visual activities. The onset of presbyopia generally occurs around age 40 and gradually worsens over time. By the time you are in need of cataract surgery most of your ability to focus up close is gone. Conventional lenses (monofocal IOL), as you’ve learned, do not allow for clear near vision after cataract surgery.
There are multiple strategies to correct presbyopia when considering cataract surgery. For some, reading glasses following cataract surgery is adequate for their needs, but for others there is a desire to be out of glasses for most activities. One strategy to improve presbyopia is to implant a special lens at the time of cataract surgery called a multifocal lens (please see lens implant section above).
A second strategy, called monovision, is to correct one eye for far vision and the other for intermediate or near vision. This is done in conjunction with cataract surgery by selecting different powered intraocular lenses in each eye so that your dominate eye sees well for distance and the non-dominant eye sees well for intermediate or near vision. This works well for most people to reduce their need for glasses. If you have tolerated this in the past with contact lenses, then you would be a good candidate for this treatment strategy. If you have not tried this in the past, your surgeon may recommend a trial in monovision contact lenses to ensure that you tolerate it well prior to proceeding with surgery. Please watch the accompanying video to learn more about this option.
Introduction To Cataract Surgery Post-Op
Post-operative Care Following Cataract Surgery
Advances in cataract surgery have made cataract surgery one of the safest and most successful surgeries performed in modern medicine. To ensure a successful recovery following surgery, be sure to follow carefully the instructions provided by your surgeon.
Please watch the accompanying video to learn more about what to expect during the post-operative period. Also, for your convenience a copy of our post-operative instructions is available for download. If you recently had cataract surgery by one of our surgeons and you have questions or concerns, please call 336-992-9637.