Cataracts

Many years ago, cataract surgery involved an overnight stay in the hospital and a lengthy recovery period. Now, we offer advanced microscopic surgical techniques and convenient outpatient facilities to make cataract surgery comfortable with minimal discomfort and disruption of your lifestyle. In addition, we offer the latest in implant technology including wavefront implants, multifocal implants and toric (astigmatic-correcting) implants. With the rapid development of new technologies, surgeons are able to customize the choice of the implant to need the needs of each individual. We participate in clinical research and advanced courses to make the latest technologies available to our patients. Both our surgeons, Dr. Musto and DeBroff are on the clinical faculty of a major university and have been teaching cataract surgery techniques to residents for many years. In addition, our doctors will be part of your entire experience from the preoperative evaluation and counseling to the surgery and postoperative care. Our goal is to work with each individual patient and help educate them to the full spectrum of choices available including the expected benefits and potential risks, so we can together make an informed choice of the best method to improve the quality of vision and the quality of life.

What is a Cataract?:
A cataract is a clouding of the normally clear lens of the eye.

Symptoms of Cataracts:
1) Blurred or Cloudy Vision
2) Difficulty Reading
3) Loss of Depth Perception
4) Glare from headlights or sunlight
5) Faded perception of colors
6) Difficulty seeing at night
7) Shadowy images
8) Double vision
9) Frequent changes in glasses or contact lenses

Causes of Cataracts
As we age the protein in the lens which is normally arranged in a very precise manner, undergoes chemical changes to cloud part or all of the lens. 80% of people over the age of 65 have some lens clouding attributable to age. Many factors have been implicated in causing senile cataracts from lack of vitamins to UV light, but other reasons for cataracts include eye injury, certain eye diseases (uveitis), medical conditions like diabetes, heredity, birth defects, medications (steroid, or even steroid inhalers), and smoking.

Treatment of Cataracts
Surgery is the only treatment for cataracts. Cataract surgery is one of the most effective and safest procedures performed today and involves removing the cloudy lens and replacing it with a substitute implantable lens (Intraocular lens or IOL). Cataracts are not treated with lasers. If the cataract is small and not bothering the vision, surgery may be postponed and a change in glasses may be sufficient. If you have cataracts in both eyes, surgery is never done at the same time.

When Should you have Cataract Surgery
You decide when it is right to have surgery. You can postpone surgery until the cataract interferes with your vision. Because everyone’s visual needs are different, this point may differ from one person to another. It is not necessary to wait until the cataract is “ripe” or totally opaque before having it removed. During your evaluation, you will be told if you are a candidate for surgery and how much improvement in vision you can expect from surgery that is free of complications. There are certain rare circumstances that may require cataract removal regardless of vision, for example if the lens begins to break down or become overripe or is releasing products that may cause glaucoma or if the cataract is preventing observation or treatment of another eye condition.

How is the Cataract Removed?
Most cataract surgery today is performed using a technique called Phacoemulsification (Phaco). We make a very small incision (less than 3 millimeteres) on the side of the cornea, the clear dome shaped surface that covers the front of the eye. A microscopic probe is placed through the inicision and ultrasound waves soften and liquefy the lens so it can be removed by gentle suction. If the cataract is very dense, a technique called Extracapsular Surgery may be needed in which we make a larger incision to remove the hard center of the lens. In almost all cataract surgeries, the removed lens is replaced with an Intraocular Lens (IOL). The IOL is permanently implanted in the eye; you cannot feel it or see it and it is not noticed by others.

Multifocal Implants (IOL’s)
IOL’s come in 2 varieties: monofocal and multifocal
Originally all IOL’s were monofocal, or corrective of vision at one distance only, whether near, intermediate, or far. Since they correct vision at just one distance, glasses are still needed. Newer, multifocal IOL’s will correct vision at multiple ranges and may eliminate the need for glasses (approximately 80% of patients may never have to wear glasses or bifocals again).
There are 2 types of multifocal IOL’s currently available:

The ReZoom IOL:
http://www.rezoomiol.com/

and

The Restor IOL:
http://www.acrysofrestor.com/

After Surgery
Vision often improves quickly (within days) and you may be surprised at how good it becomes. It does not become stable until about 4 weeks after surgery, at which time eyeglasses may be fitted to give you the best correction for distance vision and reading. No surgical results can be guaranteed. Your vision after surgery will likely be fine but it will depend on the basic health of the eye. Retina and glaucoma problems can also affect the vision.