Cataracts are natural changes in the lens of the eye. As we age, the lens clouds up and darkens, causing “fuzzy” vision, difficulty in certain lighting conditions, and glare and halos around lights. Everybody eventually develops cataracts if they live long enough; think of them as the “gray hair of the eyes!” Other causes of cataracts may include eye trauma, use of steroids, uncontrolled diabetes, and eye inflammation.
Although cataracts ultimately develop in everyone, some people may be prone to developing them earlier. Exposure to sunlight and other ultraviolet sources over years may quicken the growth of cataracts, so ultraviolet-blocking sunglasses may be beneficial. Diabetics who have their blood sugars well-controlled may not develop cataracts any sooner than average. There have been no quality studies demonstrating the benefits of vitamins or supplements in stopping or delaying the development of cataracts.
If you notice glare or halos around oncoming headlights or street lamps, find it increasingly difficult to read in dim lighting, feel that your glasses or contact lenses are not improving your vision, or perceive that colors are duller, you may be developing cataracts. Even small vision changes can signify the beginning of cataracts.
Cataract surgery is the most commonly performed procedure in the world. It is performed in an out-patient surgery center, without the need for an overnight hospital stay. The procedure takes about 5-20 minutes, and you can get back to almost all of your activities immediately! The eye is numbed with eye drops and you are given mild sedation to relax you, but since cataract surgery is considered “painless”, general anesthesia is not necessary. The cataract is removed from the natural “bag” which surrounds it, and is then replaced with a clear plastic prescription lens that is customized for your particular vision needs.
Once placed in your eye, the lens remains in place permanently, allowing you to see sharply. And unlike your natural lens, the implant does not wear out or need to be replaced. Rarely, an implant can be exchanged for one that is more technologically advanced, or for other extenuating circumstances.
This is an old and confusing term for a clouding that sometimes occurs on the back surface of the bag surrounding the implant. It is more commonly known today as posterior capsule opacification (PCO). Even though the lens itself perfectly clear, patients experience progressively foggy vision. PCO can develop as early as a few weeks or as late as several years after cataract surgery, and is completely reversible with a simple in-office procedure. A painless laser polishes the lens bag, which permanently removes the cloud, restoring the clarity of your vision.
Imagine reading, playing golf, driving, using your computer, and shopping without having to reach for a pair of glasses. Advanced technology intraocular lenses (IOLs) not only clear your cloudy vision, but also decrease your need for glasses after surgery. The most popular lens implant is called the ReSTOR. It is a multifocal lens – an implant that allows you to focus both far away and up close for near tasks such as reading. Other advanced technology implants include Tecnis multifocal, crystalens and ReZoom. The IOLs can be used during cataract surgery, or in a lens exchange procedure for those who want their distance and near vision corrected, but do not have significant cataracts.
Although most patients can qualify for this advanced technology implants, there are some limitations. If your prescription is too nearsighted, farsighted or you have a large degree of astigmatism, the lens implant alone may not correct your entire prescription. In these circumstances, LASIK or other procedures may be necessary to complete the process of vision correction. In addition, the health of your eye will greatly determine whether these IOLs will be right for you. A full dilated examination of your eyes is necessary to determine if you are a candidate for this exciting technology.
LASIK is a vision correction procedure that has very successfully treated millions of individuals. Even though LASIK may improve your vision, it does not prevent or treat cataracts, so as your natural lens ages the effects may wear off. A lens-based procedure replaces your natural lens with an implant that cannot cloud up and become a cataract. For individuals who cannot read or see up close without glasses, a lens removal procedure performed before the cataract becomes visually disabling offers several advantages. First, you will not have to worry about ever getting cataracts in the future. Second, the multifocal IOLs can allow you to read and perform various near tasks without using reading glasses. Also, unlike the natural lens an implant maintains its prescription forever. So, the vision you achieve at the end of the process is yours for life (barring any future medical changes in your eye)!
In order to determine the best implant to use for your eye, we will perform a complete ocular examination, and take extensive measurements of both of your eyes. Our staff will walk you through the procedure, discuss all the implant options based on your testing, answer all your questions, and fill out all necessary paperwork. If you choose an advanced technology IOL (ReSTOR, Tecnis multifocal or crystalens) , you will need to be out of your soft contacts for 2-3 weeks, or 3 weeks plus 1 week for every decade of wear for your RGP lenses. Like LASIK, we are attempting to get the most accurate prescription measurement possible, and we need your corneas in their natural shape.
You will go home within a half hour of the procedure. Patients may resume most of their activities immediately after the procedure, although their vision may not be stable for up to 1-2 weeks. We ask that you take it easy the day of surgery, and avoid strenuous exercise or getting the eye dirty for the following week. Aside from that, you are free to resume the majority of your activities!
Most people start to see better within a few hours. Vision is initially a little blurred as a normal response to the healing process. In addition, unlike laser vision correction, cataract surgery does not guarantee total freedom glasses. In fact, most patients who undergo standard cataract surgery usually require reading glasses. There are procedures which can decrease the need for any glasses. Examples include: having one eye’s focus set to see up close and the other eye set for distance vision (monovision), and using multifocal or accommodating lens implants. It is important to note that cataract surgery alone does not correct astigmatism, although certain implants and elective procedures can correct the condition.
When the front of the eye (cornea) is shaped like a football rather than a soccer ball, images appear stretched in one direction – like looking through a funhouse mirror. This could cause the letter “O” to appear like the letter “I”, for example. When the cornea has astigmatism, it can be corrected with either an astigmatism-correcting (toric) implant, or an additional procedure such as LASIK or limbal relaxing incisions (LRIs).
That is generally determined by you and your eye doctor. While some individuals do not need an operation on their second eye soon after their first, it is common to have both eyes operated within a short time of each other for various reasons. Once the vision in the first eye has stabilized – usually within 1 week, it is typically safe to have the second eye’s procedure. If you wear a large prescription in your glasses, or are planning on having a multifocal implant, it is often better to have the 2 eyes’ procedures relatively close together.
The best way to find out if you have cataracts or can benefit from a lens exchange procedure is to have your eyes examined. Your eye doctor can best evaluate your eyes and discuss whether you have cataracts, and whether you would benefit from cataract surgery. You can also learn about the various IOL options available to decrease your dependence on distance and reading glasses after refractive lens exchange or cataract surgery
Dr. Andrew Shatz has been performing cataract surgery for more than 19 years, and has performed over 20,000 surgeries, including thousands of refractive lens procedures. He utilizes the latest techniques, including topical clear-corneal surgery – also known as the “no needles, no stitches” technique. Dr. Shatz is a leader in the use of multifocal IOLs in the Southeast, and often lectures nationally to his colleagues about the latest techniques and advances in cataract and multifocal IOL surgery.