What Is Cataract Surgery
A cataract happens when the lens in your eye becomes cloudy and hard. The lens is the clear part of your eye that helps focus images. Cataracts can cause problems such as blurry or dulled vision, sensitivity to light and glare, and seeing shadows or ghost- like images.
Cataract surgery is the most common surgical procedure in the United States for people 65 years or older. Each year nearly 3 million Americans undergo the procedure. It involves removing an aging, cloudy eye lens and replacing it with an artificial one. Once done, cataract surgery can dramatically improve a person’s quality of life.
Cataract surgery only corrects vision problems caused by cataracts. This surgery cannot correct vision problems caused by glaucoma, diabetes, age-related macular degeneration, or other eye illnesses or injuries.
A cataract will get worse if not removed. Cataract surgery is the only way to do so. However, It is your choice when to have cataract surgery. Most people wait until their vision problems interfere with daily life.
Cataract Surgery Options
There are two main types of cataract surgery. A good eye doctor will thoroughly discuss with you the differences and help determine which is better for you:
Phacoemulsification, or phaco. A microincision using an ultrasound-based technique is made at the edge of the cornea (often less than 3 millimeters wide, which is about the size of an average pen tip). This ultrasound waves soften and break up the lens so that it can be removed by suction.
Extracapsular surgery. A longer incision (usually 10–12 mm) on the side of the cornea is done to remove the cloudy core of the lens in one piece. The rest of the lens is removed by suction. This method may be indicated for patients with very hard cataracts or other situations in which phacoemulsification is not a viable option.
After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). Lens technology has advanced so much that a surgeon must have a good reason not to replace the cataract lens with an artificial lens. Without a lens implant, or an intraocular lens (IOL), you would become very hyperopic (farsighted) and need very thick glasses or contact lenses to see anything clearly.
Wikipedia. Cataract surgery [Internet]. 2015 [cited 2015 Jul 10]. Available from: https://en.wikipedia.org/wiki/Cataract_surgery
Richardson D. So You’ve Got A Cataract?: What You Need to Know About Cataract Surgery: A Patient’s Guide to Modern Eye Surgery, Advanced Intraocular Lenses & Choosing Your Surgeon. CreateSpace Independent Publishing Platform; 2012. p. 29
Cataract Surgery Video
So, how is cataract surgery done? To give you a fuller grasp of how cataract surgery is done, watch the video playlist below. These are videos of an actual cataract surgery performed by Dr. David Richardson. These videos show a typical cataract surgery, called phacoemulsifaction. The entire procedure often takes less than half an hour.
[GRAPHIC WARNING: These videos contain actual eye surgery. Viewer Discretion Advised]
Cataract Surgery Introcular Lens (IOL) Options
Modern IOLs are made primarily of acrylic or silicone. Both materials are clear, able to refract (bend or focus) light rays, and flexible. They’re safe, and you won’t even notice that they’re there. In other words, with the advanced materials and designs used to manufacture today’s IOLs, there is little reason not to get one.
Currently, there are 2 categories of IOLs you can choose from:
Standard monofocal IOLs (Staar Nanoflex® or LensTec SofTec HD®) – These are traditional implants that have been available for many years. Your cataract surgeon could implant 2 IOLs, one for near vision in one eye, and one for distance vision in the other eye. It can provide a nice range of daytime vision without spectacles
New, advanced IOLs – These are “premium” and technologically advanced implants, such as multifocal accommodating, or toric IOLs. They can provide improved near, intermediate, and distance vision, with some even able to treat astigmatism.
- Toric IOLs compensate for astigmatism
- Aspheric IOLs correct what are called “higher-order aberrations” and offers excellent distance vision for those who do not have astigmatism
- Multifocal IOLs (ReZoom™, Alcon ReSTOR® +3, Alcon ReSTOR +4, AMO TECNIS®) This is a newer, “deluxe” type of IOL that provides distance vision AND restores a range of your eye’s ability to focus. It corrects for both distance vision and other ranges, such as near or intermediate. Choosing this option will usually lead to higher out-ofpocket expenses since most insurance companies only pay for a monofocal (single focus) lens. Another trade-off is that there will be small circles (halos) around lights at night.
- Pseudoaccommodating IOLs (Crystalens®) help you to see both distance and intermediate objects at the same time without small circles (halos) around lights at night associated with Multifocal IOLs
Your eye surgeon can help you choose the right IOLs for your cataract surgery.
No matter which IOL you choose, you may still need nighttime driving glasses. That’s because when you drive at night your pupils dilate to let more light into the eye. This dilation also slightly changes your refractive error. Current IOLs can’t correct this. Generally, however, a pair of night-driving glasses will help.
Cataract Surgery Complications
All operations and procedures are risky and can result in unsuccessful results, complications, or injury from both known and unknown causes. Cataract surgery is a delicate operation.But, it is one of the safest operations done today. More than 95% of surgeries are successful. The major risks of cataract surgery with implantation of an IOL include, but are not limited to:
- Mild discomfort. Cataract surgery is usually quite comfortable. Mild discomfort for the first 24 hours is typical, but severe pain is extremely unusual
- Capsular tear. The lens capsule is a delicate membrane and occasionally tears, allowing fragments of the cataract to slip into the back portion of the eye. This can be treated by a separate surgery at a later date. Signs of capsular tear are floaters, or bug-like objects and pecks that travel across your field of vision.
- Infection also known as endophthalmitis can potentially lead to a loss of vision. Fortunately, it is very rare. Here are signs of infection: Significant or persistent pain in or around the eye, sudden or severe loss of vision, significant discharge from the operated eye, and Nausea, vomiting or severe headache. [su_highlight background=”#fce9b3″]If you suspect an infection, call your surgeon immediately, even if it’s 3 a.m.![/su_highlight]
- Retinal detachment may occur months or years after a perfectly successful cataract procedure.This happens very rarely and often can be treated with surgery. These are the common symptoms of retinal detachment: Sudden or severe loss of vision, flashes of light or multiple, new floaters and a shadow or curtain over your field of vision.
- Inflammation or swelling which goes away after a few weeks with treatment
- Posterior capsular opacification – lens capsule shrink wraps around the IOL (eye healed a little too well) causing similar symptoms of cataracts. This can be remedied by a laser treatment.specks that travel across your field of vision.
Cataract remains the leading cause of visual impairment in all regions of the world, except in the most developed countries. According to a 2004 World Health Organization report, 47.8% of blindness worldwide is due to cataract
— Resnikoff S, Pascolini D, Etya’ale D, et al. Global data on visual impairment in the year 2002. Bull World Health Organ, 2004;82(11):844-51.
Cataract Surgery Patients Testimonial
Dr. Richardson uses only the most advanced diagnostic equipment to analyze cataracts and choose the best IOL. He has performed thousands of cataract surgeries with excellent results.
Here are some of Dr. David Richardson’s happy cataract surgery patients. They’ve been to the same journey you are about to embark upon. Listen as they share their experience.
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