What are cataracts?
As people age, the normally crystal clear natural lens of their eye can gradually become yellow and cloudy. With the loss of its transparency and clarity, the lens may begin to impair a person’s vision. The cloudy, yellowed lens is referred to as a cataract. Having cataract surgery is the only way to remove a cataract from your eye.
Symptoms of cataract:
- Cloudy or blurry vision
- Double vision in one eye
- Difficulty seeing bright lights
- Frequent changes in eyeglass prescriptions
How can I prevent cataracts?
Unfortunately, cataracts cannot be prevented. However, there are steps you can take to help slow cataract growth, such as:
- Not smoking or quitting smoking
- Protecting your eyes from direct sunlight
- Maintaining a healthy diet
- Limiting alcoholic beverages
- Keeping diabetes under control
Laser Assisted Cataract Surgery
Cataract surgery is safe, effective and quite common. If you have been told that you have a cataract, you are not alone. Each year in the United States, more than 2.5 million people have cataract surgery.
Cataract surgery is performed with topical anesthetic (numbing eye drops) in an outpatient setting. Our doctors operate while looking through a highly specialized microscope. Here, the natural lens is removed and replaced with an artificial lens (intraocular lens or IOL) implant. An incision, just large enough to allow a microscopic instrument the size of a pen tip to pass through it, is made. Through the tiny incision, a probe is inserted to gently fragment the cloudy lens and simultaneously suction out the fragmented pieces. This process is known as “phacoemulsification.” Once the cataract has been removed, a tiny new clear implant lens is folded, inserted through the small incision, and opened up to replace the natural lens. Typically, there is no patching or stitches required. New implant designs emerge every year and our doctors constantly evaluate each new type of intraocular lens implant in order to offer you the highest quality and safest device available.
This procedure is simple and virtually pain free but does require a few weeks of recuperation and care. Once you have had cataract surgery, it is recommended that you allow the eye to heal itself. In order to do so, you should avoid bright lights and be mindful of all objects that come near your eyes.
IOL Implants: Lens Replacement and Cataract Surgery
Cataract lens replacement: How IOLs work
Like your eye’s natural lens, an IOL focuses light that comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime. Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible.
Which lens option is right for you?
This common IOL type has been used for several decades.
- Monofocals are set to provide best corrected vision at near, intermediate or far distances.
- Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.
- Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called “monovision.” The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses.
Presbyopia is a condition that affects everyone at some point after age 40, when the eye’s lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.
Multifocal or accommodative lenses:
These newer IOL types reduce or eliminate the need for glasses or contact lenses.
- In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.
- The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision.
- The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes.
- It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.
Toric IOL for astigmatism
This is a monofocal IOL with astigmatism correction built into the lens.
- Astigmatism: This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.
- People who want to reduce (or possibly eliminate) the need for eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea’s shape to be rounder or more symmetrical.