Cataracts, Cataract Surgery
& Lens Implants
Having clear vision and seeing “normally” requires that light be able to pass through the optical structures of your eyes and properly focus on the retina. The two primary structures that are responsible for refracting, or bending light so that it can focus on the retina, are the cornea, which is the outermost clear curved “lens” that is visible when looking at your eye from a side view and the crystalline lens, which is located behind the colored part of the eye, or the iris, and is not directly visible. Both the cornea and the crystalline lens need to be perfectly clear in order for you to have good vision. If you are in good health and have not had chronic eye infections, inflammation or had any trauma to your eyes, the cornea is likely to maintain its clarity throughout your life. The crystalline lens however undergoes a number of changes that progress as we age. These aging changes can affect your vision.
Usually by about the time we reach the age of 40 years old, most of us begin to experience some of the visual effects that result from changes in the crystalline lens. Even if you have had “good eyes” and “normal vision” all your life, your vision is likely to begin to change in a number of ways. As we progress from our 40’s, to our 50’s and then our 60’s and beyond, the most obvious changes to our vision occurs as a result of these changes in the crystalline lens.
The two most common changes that occur in the crystalline lens are:
- A loss of flexibility, called Presbyopia, which makes it harder to read and
- A loss of optical clarity, which can cause a Cataract.
Cataracts are a common problem among the patients Drs. Schefkind & Chay see each day and are a problem experienced by a great number of people just like you. Cataracts are a common cause of vision problems among people in their 50’s and 60’s and they are actually a major cause of senior eye problems and vision loss. More than 20 million Americans age 40 and older and more than half of all Americans develop cataracts by age 80. Fortunately, with cataract surgery & lens implants Drs. Schefkind & Chay can successfully restore cataract vision loss for almost everyone. A cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision. For many patients, cataracts start out slowly and have little effect on vision at first. But, as the cataract becomes denser, so does the impact on vision.
Symptoms of Cataracts
People with cataracts often experience symptoms such as a clouding or blurring of their vision and feel they need a change of eyeglasses. Patients frequently notice and are bothered by it not being as easy to see well and comfortably in dim illumination, such as for night driving. In addition colors look faded and you may be bothered by glare, haloes, light sensitivity and a continuing decrease in your vision. These are the typical symptoms of cataracts. If you are experiencing one of more of these symptoms please be sure to let us know at your eye exam.
About Cataract Surgery
To restore vision loss from cataracts, during cataract surgery we remove the cataract and replace it with a clear permanent lens implant (IOL) in order to correct your vision. Among seniors and “baby boomers,” cataract surgery is one of the safest, most effective, predictable and common operations performed the U.S with more than 2.5 million people having cataract surgery & lens implants each year. At Schefkind Eye Care our cataract surgeons Mark Schefkind, M.D. and Edward Chay, M.D. perform the cataract operation and lens implant surgery on an outpatient basis at the INOVA HealthPlex in Springfield which offers comfortable and convenient same-day surgery and an exceptional experience.
Today, there are two methods we can use for cataract surgery.
Traditional Cataract Surgery
With traditional cataract surgery we manually make a small incision with a surgical steel or diamond blade. Then we remove the cataract by using an ultrasonic device to deliver phacoemulsification to break the cloudy lens into small pieces that we gently remove from the eye with suction leaving the capsule of the lens in place. Traditional cataract surgery is usually covered by insurance less any co-pays, coinsurance or deductible.
Laser Cataract Surgery
With laser cataract surgery we use the CATALYS™ Precision Laser to assist in making a precise, architecturally perfect incision as well as to soften the cloudy lens material so it is easily aspirated and gently removed from the eye, again leaving the capsule of the lens in place. In some instances we can also correct small amounts of astigmatism with the laser to help you achieve your best vision correction. By using the high resolution imaging device coupled that with an advanced femtosecond laser we are able to deliver greater reproducibility, precision, safety and a gentler cataract surgery procedure. There is an additional cost for laser cataract surgery that is typically not covered by insurance.
The Cataract Surgery Procedure
The preparation for your cataract operation will begin with a few sets of drops being placed in your eye to dilate your pupil. Additionally, your eye will be treated with anesthetic drops to numb the surface of your eye so that you will feel little if any discomfort during your cataract surgery. In addition you will be given IV and/or oral medicines to help you relax if desired. Patients often ask us whether we prefer the use the laser for cataract surgery. Cataract surgery is technically complex and requires considerable surgical skill in order to perform the great number of manually delivered steps required. In fact, for many patients we do in fact recommend performing laser cataract surgery using the CATALYS™ Precision Laser in order to provide exquisite reproducibility, precision, safety and a gentler cataract surgery procedure with a quick visual recovery. The entire procedure usually takes less than 20 minutes and is painless.
About Lens Implants
During your cataract exam and preoperative measurement visit, Drs. Schefkind & Chay and the staff will discuss choosing a cataract lens implant to correct your vision and help you see clearly.
There are several types of lens implants (IOL) that we can use in order to provide you with the best results to match your lifestyle and activities after cataract surgery. These different types of lens implants include Monofocal Lens Implants which are the most basic type of lens implant and only correct distance vision and not arms’ length or close reading vision, Toric Lens Implants for those patients with astigmatism and Presbyopia Correcting Multifocal Lens Implants such as the AcrySof® IQ PanOptix™ Trifocal Lens Implant, and the AcrySof™ IQ Vivity™ Extended Vision Intraocular Lens which correct distance vision, as well as arms’ length vision and close reading vision for most patients. Drs. Schefkind & Chay may recommend multifocal cataract lens implants to correct vision at distance, arm’s length and up close so that you can reduce your dependence on glasses after cataract surgery. To help decide which type of cataract lens implant is right for you we take precise ocular measurements as part of the preoperative process. With these measurements, combined with your lifestyle needs we can discuss the best lens option for your surgery. We will take the time necessary to answer all of your questions so you can relax on the day of your surgery.
ORA Guided Cataract Surgery
ORA (Optiwave Refractive Analysis) system technology is a sophisticated device that provides real time measurements of your eye during cataract surgery. ORA measurement allows us to take eye measurements in the operating room to optimize decision making for correcting the vision. We use this technology to fine tune lens choices, measure residual astigmatism that may need to be fixed and verify the proper position of a toric lens implant. The ORA technology becomes very important in situations where the measurements taken in our office may not be perfectly reliable. One example is for patient’s that have undergone previous refractive surgery such as LASIK or PRK or in cases where there has been previous eye injury or surgery.
What Happens After Surgery?
It is recommended that you return home after your surgery and avoid any strenuous activity for the remainder of the day. You can watch TV, do some light reading, and eat whatever you feel up to. You should avoid any lifting and exposure to dirty or dusty environments. Do not drive for the remainder of the day. It is quite common for vision to be blurred on the day of surgery and to experience some mild scratchiness or irritation. Significant pain is unusual and warrants a call to our office. We will arrange to see you within 24 hours of your cataract & lens implant procedure so we can examine you in order to confirm that you are healing and seeing as planned. We will also prescribe some eye drops for you to use and may ask you to wear a protective shield, mainly at night, to remind you not to accidentally rub your eye. Although each patient will heal a little bit differently, the majority of patients having cataract surgery with Drs. Schefkind & Chay are able to see well enough to return to their routine daily activities within a day or so after their procedure. Our staff can further advise you on resuming activities at your 1 day postoperative appointment.