How does cataract affect your vision?
Your eye has a clear lens through which light passes, allowing you to see. When the lens loses its transparency, the cloudy tissue that develops is known as a cataract.
Cataracts cause progressive, painless loss of vision. The lens clouds naturally as we age, so people over the age of 65 usually see a gradual reduction of vision. No one is exactly sure what causes cataracts. In younger people they can result from an injury, certain medications, or illnesses such as diabetes. Prolonged exposure to ultraviolet light may also play a role in the formation of cataracts. Studies have also shown that people who smoke cigarettes have a higher risk of developing cataracts than non-smokers.
Although cataracts usually develop without apparent pain, some indications that a cataract may be forming are:
- Blurred or hazy vision
- Double vision
- Poor vision in bright light
- Seeing halos around lights
- Yellowish tinged vision
- Night vision difficulty
If visual impairment interferes with your ability to read, work, or do the things you enjoy, then you will want to consider cataract surgery. Surgery is the only proven means of effectively treating cataracts. Cataract surgery is a relatively painless and is one of the most frequently performed procedures. It has a very high success rate and more than 90 percent of cataract surgery patients regain useful vision.
We perform a minimally invasive, no-stitch cataract surgery called phacoemulsification ("phaco") surgery. First, the eye is numbed with anesthesia. Then a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces and gently sucks, or aspirates, those pieces out of the eye (Step 1 below). Step 2 is the placement of a new, artificial lens called an IOL.
Selecting the Right IOL
Following surgery with traditional artificial lenses, patients often still need to use their reading glasses or bifocals to be able to read objects at close range. This is because traditional artificial lenses implanted during cataract surgery typically only correct for distance vision. There are a variety of IOLs that can be used in cataract surgery, and they each have their own set of advantages and disadvantages. No single IOL works best for everyone, and only your ophthalmologist can determine the most appropriate IOL for your needs.
Fixed Focus Monofocal IOLs are used in the majority of cataract procedures. These lenses have the advantage of excellent quality distance vision under a variety of lighting conditions. Since these lenses have a fixed focal point which is generally set for distance vision, reading glasses are typically required for good near vision. For patients willing to use reading glasses for near tasks, these IOLs are an excellent choice. Several million lenses of this variety have been used for decades with an excellent safety record.
There are several newer types of Accommodating or Multifocal IOLs that use different strategies to achieve good distance and near vision without glasses. Accommodating Monofocal IOLs have a single focal point, however, the focal point can shift position in space so that objects at distance are clear when the eye focuses on them, but when the eye looks at a near object the IOL will shift its focal point to bring the near object into focus. Multifocal IOLs have highly specialized optical properties that can divide light to bring it into focus at more than one point at the same time. This allows the eye to see both near and far, usually without glasses. Excellent results for distance and near vision have been achieved by both of these FDA approved lenses. Multifocal IOLs have a slightly greater tendency to cause night vision complaints than other IOLs, so consultation with Dr. Tauber prior to surgery is important to decide on the best IOL for you.
LASER-ASSISTED CATARACT SURGERY
Eye surgery is a branch of medicine where equipment and techniques are constantly evolving. Lasers have revolutionized the way vision problems are treated. In fact, LASIK and laser eye surgery really didn't even exist just 30 years ago! Now there is a new advance that can dramatically improve the lives of patients with cataracts: laser-assisted cataract surgery.
The computer-guided laser automates the first steps in the cataract surgery procedure:
(click for informational video, use BACK button to return: LenSx and http://youtu.be/UnT7lqZGHxc)
These are 1. the initial incisions; 2. the opening of the lens “bag” (called capsulotomy); and 3. the breakup and removal of the cloudy natural lens. These steps, traditionally performed with hand-held instruments and ultrasound probes, can be performed by a fast, accurate laser.
This leads to improved precision and safety, which means better outcomes for patients. Detailed explanations can be provided by our staff and doctors, but key advantages are:
Laser-precise incisions • More accurate lens centration • Gentler and easier cataract removal
Opening the lens capsule with a laser is more precise than any surgeon can make by hand. This opening provides the surgeon access to remove the cataract. The capsule also serves as a “platform” to hold the lens implant. If the opening is not centered or uniform, the lens implant may tilt or move as the capsular bag heals, compromising the desired outcome. Studies suggest that the chance of inaccuracy with laser openings is 10 times lower than “hand-made” openings.
During surgery, after the opening is made, the lens is separated from the capsule and “chopped into pieces” with ultrasonic power (sound waves). Certain complications, including tears in the capsule, can occur during
this step, depending on how much power is needed to break up the cataract. The laser can be used to pretreat - to gently break up or even liquefy the cataract. Surgeons can then remove the softened cataract more quickly and with much less ultrasound power or may even be able to vacuum it out with no
ultrasonic power at all. Studies have shown that using the laser – assistance
allows 40-50% reduction in needed power to break up the cataract.
Improved surgical accuracy and greater safety are our goals in offering this advancement in traditional cataract surgery. To learn more about laser-assisted cataract surgery, contact our friendly staff to make an appointment. Our doctors will be more than happy to determine whether you might benefit from this advanced and revolutionary procedure.