Cataracts

Being diagnosed with cataracts means that the natural clear lenses you were born with have become opaque or hazy.  A cataract is not a growth on the eye, but the lens itself becoming opaque.  The lens is inside your eye just behind the iris which is the colored part of the eye. The lens is responsible for focusing the light onto the retina in the back of the eye just as a camera lens would focus light onto the film in a camera. Cataract surgery involves removing the entire lens and replacing it with a new clear man made lens implant. This lens implant remains inside the eye permanently and does not require care or planned exchanges like contact lenses.

Until about the age of 40 your lens is able to accommodate.  This means it can change its power to allow near vision even when the distance vision is corrected. After this time, accommodative power begins to weaken and people need bifocals or reading glasses.  This loss of accommodation is called presbyopia. Some people with pre-existing myopia (nearsightedness) can remove their distance glasses to see up close.  When the lens/cataract is removed, any residual accommodative power is lost, but the patient has the benefit of being able to choose the power/type of their new lens implant to customize the result to their specific needs.  None of the implant options guarantee that you will be free of glasses, but patients often have a reduced dependence on glasses. Most patients choose to have distance vision lens implants in both eyes and then wear reading glasses.  Some of these patients will choose to wear bifocals if they do not like keeping track of these "readers".  Other patients will choose to be left nearsighted to do near work without glasses and are willing to use glasses for all other activities. For the right patient, another option is to do "monovision" which is distance vision in one eye and near vision in the other, usually non-dominant, eye. This reduces the dependence on glasses even more, but can be uncomfortable for some.  Newer options include "pseudo-accommodative" or accommodative lens implants that allow both distance and near vision in both eyes. This can be a nice advantage, but there is a higher risk of seeing glare or halos around headlights or decreased ability to see contrast due to the nature of their design.

Cataract surgery is an outpatient procedure that generally takes about 15-30 minutes and is usually done under local/topical anesthesia.  Patients are understandably nervous about being awake for eye surgery, but are routinely very surprised at the ease and comfort of the procedure. Patients usually return to their normal activities within a few days.

The usual routine involves starting antibiotic and anti-inflammatory drops 1-3 days before surgery and then a tapering course of drops over the next few weeks. These drops decrease the chance of infection, increase comfort and allow a faster and more complete restoration of vision.  A few weeks after the surgery new glasses may be prescribed as needed.

About 15-20% of patients will develop an "after-cataract" in the weeks, months or years after the surgery. This means the lens capsule (the transparent membrane around the original lens/cataract) that holds the lens implant itself becomes hazy. Fortunately this is easily treated in the office with a painless laser that takes just a couple minutes.

 

 

 

 

 

 

 

 

Ophthalmic Associates - PHONE: 1-800-270-1617 - 907.276.1617 - FAX: 907.264.2687