A cataract is a cloudy area in the lens of the eye. Generally it's associated with the normal aging process.
Cataracts usually develop very gradually as we get older, and they may run in families. They develop slowly and painlessly, and vision in the affected eye or eyes worsens over time. But eventually we're all going to get them.
Cataracts develop more quickly based on environmental factors such as smoking, exposure to other toxic substances, and exposure to excessive ultraviolet light or sunlight. They also may develop at any time as the result of an eye injury. Diseases such as diabetes also greatly increase the risk for cataracts.
Cataracts usually lead to decreased vision, even in daylight. Most patients with cataracts have similar changes in both eyes, although one eye may be worse than the other. Some patients will experience only mild vision changes that do not necessarily require surgery. There could be color changes or glare. They may be able to get by with changing glasses or getting stronger bifocals.
The patient and his or her Cool Springs EyeCare or Donelson EyeCare doctor will decide if the decreased vision from cataracts does not allow proper visual function, thus requiring surgery. Surgery is the only option to remove cataracts.
What's new in cataract surgery?
The good news is that for 15 years now cataract surgery has been performed with no shots, no drops, no patch and no pain.
The two newest advancements are the size of the incision and the type of implant.
The incisions are virtually microscopic. One area doctor is making a 1.8-millimeter incision. Smaller incisions mean quicker healing time and less chance for infection.
We always put a clear implant in when we remove a cloudy human lens. Before, the standard implant was very good for distance vision, but you still needed reading glasses. Now we use a "progressive implant, a multifocal intraocular lens. For many of our patients this lens will provide not only clearer vision but will minimize the need to wear glasses at all.
What are my options as far as lens implants?
There are four primary intraocular lenses from which to choose. Each has demonstrated effectiveness in improving near, intermediate and distance vision in FDA clinical trials, and we have patients who report success with all of them.
- The AcrySof® IQ ReSTOR® multifocal intraocular lens. This lens uses patented technology that is akin to a microscope or telescope. The center of the lens surface consists of a series of tiny rings that work together to focus light, which also is known as apodized diffractive optic. The ReSTOR lens provides excellent range of near vision, which includes focal points 16 inches or closer to your eye.
- The Bausch & Lomb Crystalens®. This lens is the first and only FDA-approved accommodating intraocular lens. What does that mean? An "accommodating lens moves and changes shape using the eye's natural focusing mechanism instead of remaining fixed and stationary within the eye. It uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens focuses only one image to the back of the eye, unlike a multifocal lens that projects multiple images. Crystalens allows the eye to focus across a range of distances to reduce or eliminate dependence on glasses. In particular, this accommodation provides significant advantages in addressing intermediate vision.
- The AMO Tecnis® multifocal intraocular lens. This lens is the only full-surface diffractive aspheric IOL. It was designed this way to correct for certain, more complex vision errors (i.e. higher-order aberrations) because it helps improve the ability to see contrasting objects, particularly at night. The Tecnis uses concentric refractive zones to create multifocal vision. Diffractive rings start close to the center of the lens and move out toward the periphery with an increasing distance between them. This design performs well regardless of pupil size. Even patients with relatively small pupils will gain excellent near vision. The Tecnis also performs particularly well in low-light situations.
- The ReZoom® multifocal intraocular lens. This lens is a clear, foldable implant made of a high refractive index acrylic material. This new technology is designed to provide a full range of vision. The ReZoom has a patented lens design called Balanced View Optics Technology. This design creates five focal points or "visual zones so patients can see well at a variety of distances. Unlike other earlier multifocal lens designs, the ReZoom has proportioned the size of its zones to provide for good vision in a range of light conditions.
What can you tell me about the surgery?
The entire procedure generally is done on an outpatient basis and usually lasts 10-20 minutes. Patients should experience little to no pain and in most cases can return to their normal activities the following day.
Yes, that's a dramatic change from what many of you will think when you hear the words "cataract surgery. If you know someone who had it more than 15 years ago, you'll remember the giant protective sunglasses and such mantras as "don't bend over and "keep your head above your heart. Today's reality is there are very few post-surgery restrictions. You can have mostly unlimited activity except for staying out of dirty water and dirty air for a week or two.
The surgeon will make a small incision at or near your cornea and insert an instrument about the size of a pen tip to assist in removing the cloudy lens. Once the natural lens is removed, the IOL is inserted through the same incision and placed into its permanent position.
Cataract surgery is one of the safest and most effective medical procedures. More than 3 million cataract surgeries are performed each year. But remember, it's surgery, and inherently there are risks. Still, some area doctors report more than a 98-percent success rate.
The doctors at Cool Springs EyeCare and Donelson EyeCare will consult with you on the front end to help you decide on a surgeon who is right for you and your cataracts. Patients also will have a post-surgery follow-up at Cool Springs EyeCare or Donelson EyeCare, and we'll set up a series of continued checkups in to make sure everything is on track for your continued best vision.
How do I take the next step?
If you're wondering whether you have cataracts consult with your doctor at Cool Springs EyeCare or Donelson EyeCare. They will determine if you do and what the proper course of action is. As was noted, cataracts don't necessarily require surgery. If you have them, you and your doctor can discuss the many options available. If you and your doctor believe that surgery is your best option, your Cool Springs EyeCare or Donelson EyeCare doctor will set up a pre-operative treatment plan and decide which implant is best for you and your vision goals. Our goal is to preserve and maintain your optimal eye health. Call and make an appointment today.