Cataract Overview

Over the past decade, there have been revolutionary changes in the way cataracts are removed. This has made the operation even more successful. Patients can generally expect outpatient cataract surgery with little to no discomfort under local anesthesia. Most patients will have no-stitch small incision surgery, and should be able to return to their normal lifestyle shortly after the operation.

Most cataracts occur as part of the aging process, from a change in the chemical composition of the lens. They usually do not become a problem until you are in your 60s or 70s. If you live long enough, you are almost certain to develop one eventually. Some, but not all, scientists feel that prolonged exposure (over years) to sunlight can damage the lens and plays a role in cataract development. Cataracts can also be caused by eye injuries, certain eye diseases and medical conditions, hereditary or birth defects, and, occasionally, some medications. They are not caused or made worse by using or “overusing” the eyes. There are different types of cataracts, including nuclear cataract, cortical cataract and posterior subcapsular cataract.

You can tell if you have a cataract if you have noticed a gradual blurring or dimming of vision. Some people see a “halo” or haze around lights, especially at night, or have hazy or double (or multiple) vision. At first, the symptoms may occur only in dim light or when you face bright oncoming car headlights; the glare may make night driving especially difficult. Pain, headaches, and eye irritation are not usually symptoms of cataract.

Cataract Symptoms

It is possible to have a cataract and not notice it. If the cataract is small, it may not disturb your vision or cause any symptoms at all. Even a dense cataract may not be noticed if the other eye is providing clear vision. In fact, you might not be aware of the blurred vision unless you happened to cover the normal eye. Unless it is very dense, a cataract is not visible to the naked eye of an observer. Once a cataract begins, no one can predict how fast a cataract will develop. Generally, the clouding of the lens progresses slowly and gradually over a period of months or years. It is not known why some cataracts progress rapidly and others progress slowly..

In recent years, new and better techniques have been developed for correcting the optical problems caused by having a cataract removed. One of them, the intraocular lens implant, is a tiny piece of plastic that is a permanent replacement for your natural lens. You never take it out, and it requires no care. You cannot feel it or see it, and it is not noticed by others. Today, almost all cataract surgery patients choose to have their cataractous lens replaced by an IOL.

Cataract Treatment

At present, the only effective treatment is surgical removal of the cloudy lens. In no-stitch surgery, a cataract is removed by making a small incision into the front of the eye. The incision is tunnel-like and self-seals when the surgery is completed, reducing recovery time. A highly sophisticated ultrasound instrument is inserted into the eye that breaks up the opaque lens into tiny fragments that are then suctioned out through the instrument’s hollow tubing.

The success of cataract surgery in restoring sight is about 95%. It is one of the most effective and safest operations performed today. The high success rate is due to advances in microscope technique, high-tech instruments, ultrafine needles and use of intraocular lenses.

Intraocular Lenses

During cataract surgery, artificial lenses are implanted in the eye to replace the cloudy natural lenses. These artificial lenses, known as intraocular lenses (IOLs), were once only able to correct distance vision, leaving patients dependent on eyeglasses or contact lenses for near vision. Many cataract patients, in addition to suffering from either nearsightedness or farsightedness, also suffer from presbyopia, natural changes to the eyes that occur as we age.

Before premium lenses, patients were unable to see clearly at both near and far distances without the use of eyeglasses or contact lenses. Early lens implants were monofocal, meaning that they had only one focal point and could not adjust to varying distances.

New advances in technology have allowed for the development of multifocal IOLs, which let patients see clearly at all distances, and can even correct astigmatism as well. Premium lens implants are ideal for cataract patients who are also suffering from presbyopia and want a replacement lens that provides a full range of clear vision.

There are several different types of premium lens implants available for cataract patients. Your doctor will work with you to decide which lens is best for your individual eyes to help you enjoy long-lasting, clear vision at near, intermediate and far distances. To speak with one of our doctors and discuss your options for cataract replacement lenses, please call us today to schedule a consultation.

Toric (Astigmatism-Correcting) Intraocular Lenses

Toric IOLs are used as a replacement lens in cataract surgery for patients with astigmatism. In addition to replacing the cloudy lens affected by cataracts, Toric IOLs correct astigmatism as well as nearsightedness or farsightedness. This lens also features an advanced aspheric option that improves image quality and increases contrast sensitivity. The Toric IOLs are a light yellow color that helps filter out blue light without affecting the color or quality of the patient’s vision.

Although Toric IOLs are not accommodating and may still require eyeglasses or contacts to be worn, they offer many advantages to patients with astigmatism. Most patients report a high level of satisfaction with the Toric IOL lens, as it is the only lens to effectively treat astigmatism in cataract patients.

Multifocal (Presbyopia-Correcting) Intraocular Lenses

In December 2008, ReStor® the latest IOL by AcrySof was approved for use in the US. The ReStor® 3.0 lens allows cataract replacement with +3.0 diopters, adding power at near, intermediate and distance vision. Acrysof lenses have been the number one choice for cataract patients with presbyopia since they were introduced in 2005. This lens allows patients to enjoy improved comfort and vision for reading, computer work and distance vision with the same safety and reliability as previous AcrySof lenses.

With the ReStor 3.0 lens, most patients are satisfied with their vision after surgery, and many more were able to enjoy 20/20 vision at all three distances than with the previous ReStor +4.0 D lens. Clinical results included a three-month follow-up exam showing that many patients would choose to have this lens implanted again.

Manufactured by Abbott Medical Optics, the Tecnis® Multifocal IOL helps cataract patients achieve clear vision at all distances after surgery, including improved night vision and driving capabilities. Using wavefront technology, the Tecnis lens allows patients to restore the clear, functional vision of their youth. After surgery, up to nine out of ten patients no longer need to wear glasses, results much more successful than those achieved with standard multifocal lenses. It is the only lens FDA-approved to enhance functional vision and night-driving performance.

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