A cataract is a condition of the natural (crystalline) lens inside your eye. The lens is located behind the iris and functions just like the lens of a camera ¬- focusing light images on the retina. When this lens becomes cloudy (develops into a cataract) the light cannot pass through the lens to reach the retina. Much like trying to take a picture with a foggy camera lens. There are several things that can cause a cataract such as trauma, certain diseases, some medications, but most commonly, it is caused by the aging process. Regardless of the cause, the result is blurry vision, dull colors and problems seeing well enough to drive safely at night. Eventually, adjustments to a person’s eyeglass prescription does not help and the only option for better vision is to surgically remove the cloudy, diseased lens and replace it with an artificial one (intraocular lens or IOL).
The ideal time to have your cataracts removed is when the quality of your vision begins to put limits on your activities and enjoyment of life. The days of waiting until they are “ripe” are long gone. In fact, waiting too long to remove a cataract significantly increases the risk of complications. Advancements in cataract surgical procedures and lens implant technology have made it one of the safest and most successful surgeries that you can have. In the United States over 2.5 million people have cataract surgery each year.
Your cataract will be removed with an advanced small incision technique called phacoemulsification. After your eye is completely numbed with topical anesthetic eye drops, a very small, self-sealing incision is made in a predetermined area of the cornea. A tiny ultrasonic probe is used to break apart the cloudy lens and gently remove it. Then, a carefully selected, intraocular lens (IOL) is inserted into the same membrane that held your natural lens.
If you are considering cataract surgery, there are several vision correcting options available that give you the opportunity to have distance and near vision after cataract surgery, without dependence on glasses or contacts. The following are is a list of conditions and options that Dr. Ply will discuss with you at your exam:
- Mono-focal Lens Implants
- Accommodating Lens Implants
- Multifocal Lens Implants
- Astigmatic Keratotomy
Dr Ply performs this advanced surgical treatment on site at our attached ASC; and provides along with Dr Thomas, all of your care before, during and after your treatment. This nearly painless 20 minute outpatient procedure can give you dramatically improved vision the next day, with little to no 'downtime'. This is probably the most important decision you need to make about your cataract surgery, so please take the time to review your options and ask questions.
Patients who have cataracts will eventually develop, or already have, presbyopia. This condition is caused by the natural aging process and develops when your eye loses its ability to shift from distance to near vision. Presbyopia is the reason that reading glasses become necessary, typically after age 40, even for people who have never needed glasses before. Years ago the only options for correcting presbyopia, before or after cataract surgery, were: bifocals, reading glasses and monovision. Now, with recent advancements in intraocular lens implant technology, Dr. Ply can correct or reduce the effects of presbyopia. Enhancing your quality of life by reducing or eliminating your dependence on glasses or contacts!
Lens Implant Options
In the past, the choice of which type of lens implant to have, was made by the surgeon. Patients were not given an option because there were no options. Only mono-focal lenses were available. A mono-focal lens, often referred to as a “standard or traditional” lens, is a single vision lens that provides distance vision only. These lenses do not correct presbyopia or corneal astigmatism, in fact they can make the effects more noticeable and less tolerable. Patients that choose a mono-focal lens implant will need glasses or contacts for best visual acuity after surgery. With recent advances in IOL technology, patients having cataract surgery now have the option of reducing their dependency on eyeglasses – at all distances, with accommodating and multifocal lens implants.
Crystalens® is an accommodating lens implant featuring innovative hinges that allow it to move naturally with muscles in the eye. This lens restores the eye’s ability to “accommodate” or shift focus between nearby and distant objects. It provides a functional range of vision therefore reducing or eliminating the need for glasses or contacts.
ReSTOR® is a multifocal lens implant featuring a dual optic design that incorporates both distance and near powered lenses into one lens. These optic zones work together by bending light and focusing it on the correct point on the retina. This provides enhanced image quality and a full range of vision-up close, far away, and everything in–between–giving cataract patients the opportunity to live life free of glasses.
Astigmatism is an abnormality in which the optical surfaces of the eye are shaped like a football (oval) rather than a baseball or basketball (round). Astigmatism is the most common optical problem after myopia (nearsightedness) and hyperopia (farsightedness). When it is uncorrected, astigmatism blurs vision at all distances, near and far. Overall astigmatism is approximately the sum of what is in the cornea and what is in the lens. Cataract surgery eliminates the lens component of astigmatism. Any amount remaining in the cornea will contribute to reduced image quality without glasses following surgery. Some people have no astigmatism in their eyeglass measurements, yet they have astigmatism in their corneas. The only way of knowing if corneal astigmatism is present is to test for it.
AK (Astigmatic Keratotomy)
To correct corneal astigmatism, Dr. Ply precisely places small incisions in the steep axis of the peripheral cornea. The specific location and depth of these incisions are determined by advanced computerized testing prior to your procedure. This causes the cornea to relax and become more spherical allowing light rays to focus at one point on the retina, resulting in improved vision. When combined with cataract surgery and mono-focal lens implants, most patients find that their vision is improved to the level that eyeglasses are not required to drive or see well at a distance. When combined with cataract surgery using Crystalens® or ReSTOR® lens implants, most patients see well at a distance, intermediate range, and near, without dependence on glasses or contacts!