ProvidersGeorge J. Alter, MD Walter G. Atlas, MD Ernest Bhend, MD Pedro Cervantes, MD Adrian J. Elfersy, MD Robert A. Flores, MD Sumit K. Gupta, MD William M. Hammonds, MD Wei Huang, MD, PhD Scott L. Jaben, MD Priyanka Kanakamedala, MD **STARTING SEPTEMBER 2019** Kashyap B. Kansupada, MD, FACS James G. Kaufmann, MD Barbara Lee, MD Casey Mathys, MD Veena Rao, MD Joshua A. Rheinbolt, MD Rachel P. Sabo, MD Robert M. Saltzmann, MD, FACS Nehali V. Saraiya, MD Craig S. Self, MD Vipul C. Shah, MD Donald H. Stewart III, MD David N. Ugland, MD Boyd K. Vaziri, MD Brent B. Warren, MD
CATARACT CARE AT CEENTA
Cataracts are a condition that everyone will deal with as they age. More than 24 million people in the United States are affected by cataracts, and by the age of 75, about half of all Americans have cataracts. While usually painless, cataracts can affect your vision and quality of life.
The cataract surgeons at CEENTA can see you in any of 12 locations to determine if you have cataracts and need surgery. Our doctors offer both custom and laser cataract surgery and a variety of lenses to suit your lifestyle needs. Our surgeons perform nearly 10,000 cataract surgeries every year, so you know you’ll be in expert hands.
WHAT IS A CATARACT?
Your eye works a lot like a camera. Light rays focus through your lens onto the retina, a layer of light-sensitive cells at the back of the eye. Similar to photographic film, the retina allows the image to be “seen” by the brain.
Over time, the lens of our eye can become cloudy, preventing light rays from passing clearly through the lens. The loss of transparency may be so mild that vision is barely affected, or it can be so severe that no shapes or movements are seen—only light and dark. When the lens becomes cloudy enough to obstruct vision to any significant degree, it is called a cataract.
WHAT CAUSES CATARACTS?
Aging is the most common cause. As you age, the lenses in your eyes become less flexible, less transparent and thicker, clouding small areas within the lens. As the cataract continues to develop, the clouding becomes denser and involves a greater part of the lens.
Cataracts may develop in only one eye, but they usually develop in both of your eyes. However, they usually aren’t totally symmetrical, and the cataract in one eye may be more advanced than the other.
Cataracts usually form slowly and cause few symptoms until they noticeably block light. When cataract symptoms are present, they can include:
- Vision that is cloudy, blurry, foggy, or filmy
- Changes in the way you see color because the discolored lens acts as a filter (fading or yellowing)
- Glare, particularly at night
- Double vision (like a superimposed image)
- Sudden or frequent changes in glasses prescription
- Increasing age
- Drinking excessive amounts of alcohol
- Excessive exposure to sunlight
- Exposure to ionizing radiation, such as that used in X-rays and cancer radiation therapy
- Family history
- High blood pressure
- Previous eye injury or inflammation
- Previous eye surgery
- Prolonged use of corticosteroid medications
WHAT IS CATARACT SURGERY LIKE?
Cataract surgery is an uncomplicated, straightforward, painless procedure that usually takes around 15 minutes. Generally, your doctor will make a minor incision in your eye. A small ultrasound probe will break up and remove your cataracts, and a new lens will be placed in your eye. Stitches are usually not required, and a bandage or patch will be placed over your eye to protect it afterward.
CHOOSING THE RIGHT CATARACT LENS
There is a variety of options for intraocular lens implants used to restore patients' vision. These implants are placed during the cataract procedure. Options may include implants that correct for distance, intermediate and near vision as well as astigmatism. CEENTA surgeons use a variety of implant types including the Symfony implant with Extended Depth of Focus, the ReSTOR and Tecnis multifocal implants, toric (astigmatism) implants and monofocal implants as well as implants for monovision. Once you have decided to proceed with cataract surgery, discuss with your surgeon which of these options are best suited for your situation.
While there is no way to test a lens before it is implanted, your lifestyle can help you determine which lens would be best for you. Factors can include the activities you do, the distances you need to see most clearly without glasses, and what you can afford to pay through your insurance and out of pocket.
TYPES OF LENSES
Monofocal lenses: Monofocal lens implants allow you to focus at only one distance. The cloudy lens is removed and the new lens provides a single point of focus on your retina. Typically, most patients prefer to set their implant to see at a distance, so you would need to wear glasses for near vision. Some patients may choose monovision, whereby they might be able to reduce their dependency on glasses. Monofocal implants are typically covered by Medicare and private insurance carriers. Toric and Extended Range lens implants, on the other hand, have an additional out-of-pocket expense that is not covered by Medicare or private insurance carriers.
Monovision: Some patients choose to get monofocal lenses with different focal points, so one eye is set for distance vision and one for near vision.
Multifocal lenses: Multifocal lenses give you multiple focal points for near and distance vision, and are designed to reduce your need for glasses.
Toric lenses: Toric lenses are designed to treat astigmatism and provide clear distance or near vision. These implants are like monofocal lenses in that they provide a single point of focus. Typically, most patients prefer to set their implant to see at a distance, where they would need to wear glasses for near vision. Some patients may choose monovision if they have previously enjoyed monovision with contact lenses.
Symfony IOL: The Symfony Intraocular Lens is an Extended Depth of Focus implant. Similar technology has been used for years in microscopes and telescopes. These lenses improve image quality, contrast in dim light, and color saturation. This lens implant provides a continuous range of near, intermediate, and far vision, whereby most patients are able to reduce their dependence on glasses. The Symfony also comes in a toric version to treat astigmatism at the same time.
ReSTOR Multifocal IOL: These lenses feature an “apodized diffractive” design that distributes light to distant and either intermediate or near focal points, whereby most patients are able to reduce their dependence on glasses. Some patients may find they need additional light to see in dim lighting conditions from this technology, which may become less noticeable over time. The Restor also comes in a toric version to treat astigmatism at the same time.
Tecnis Multifocal IOL: The Tecnis Multifocal Intraocular Lens allows you to see at near, intermediate, and far distances under any lighting conditions. Tecnis offers three Multifocal lens options, each of which is geared to meet your specific lifestyle needs. The +2.75 lens is for someone who does a lot of activities that require intermediate vision. The +3.25 lens is for people who do a lot of work at a desk. The +4.0 lens is for those who need improvement in their vision for tasks like reading or sewing.
Some physicians also use lasers in cataract care. Femto Laser Assisted Cataract Surgery, or FLACS, reduces the astigmatism by relaxing the cornea at a precise depth, length, and orientation. The Femto Laser also replaces many of the steps during cataract surgery that require a blade – making this a bladeless procedure – and softens the cataract, allowing for an easier and smoother removal.
When used in conjunction with multifocal lens implants, most patients enjoy a range of vision from near to far without glasses that they haven't seen their entire life.
After surgery, you will still be groggy from the anesthesia and will need someone to drive you home. You will be given a pair of sunglasses to protect your eyes during the drive. You will also be given an eye shield to wear when you sleep.
Some patients report clear vision after only a few hours, but it's not uncommon for patients to take a week or two for their vision to regain their sharpest focus. Do not be alarmed if your vision is cloudy or blurry after you first remove your eye shield.
You will have a follow-up appointment with your cataract surgeon the day after surgery to make sure there are no complications. Tell your doctor if you don't notice any improvement in blurry vision or you feel eye pain or significant discomfort.
Your doctor will prescribe antibiotic and anti-inflammatory eyedrops, which you will need to apply daily.
You should not perform any strenuous activity for a few weeks. You should also avoid bending over, to avoid putting additional pressure on the eye. You should avoid swimming or exposing your eye to irritants. Do not rub your eye.
Would I ever need my cataract surgery redone?
No. Once the clouded lens is replaced, you cannot get another cataract in that eye.
Your lifestyle isn’t the only thing you should consider before choosing a cataract lens. Your eye health can also affect it. For example, eye conditions such as glaucoma, macular degeneration, or astigmatism can cause problems with certain types of lenses.
While this is a good introduction to the many options you have for cataract lenses, you should discuss your choices with your ophthalmologist before making a decision.