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 Kashyap B. Kansupada, MD, FACS James G. Kaufmann, MD Ian Kirchner, MD Barbara Lee, MD Casey Mathys, MD Payal S. Patel, 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 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
Once your surgeon removes your cataract during surgery, he or she must place an intraocular lens (IOL) implant to help you see. 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.
While there is no way to test a lens before it is implanted, your lifestyle and overall eye health 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 one distance. Typically, most patients prefer to choose their implant to see at a distance, so you would typically need to only wear glasses for near vision.
Monofocal implants are typically included with 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 included with 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. This is typically chosen by people who have enjoyed monovision in the past with contact lenses or LASIK.
Extended Range Implants:
Presbyopia is the gradual, age-related loss of the ability to see things clearly up close. Extended range intraocular lenses are designed to give the patient multiple focal points at distance, intermediate and near vision ranges in order to help reduce and often eliminate the need for glasses. These include multifocal IOLs, trifocal IOLs, extended depth of focus IOLs, and accommodative IOLs.
Examples of Extended Range IOLs include:
- PanOptix Trifocal
- ReSTOR Multifocal
- Symfony Extended Depth of Focus
- Tecnis Multifocal
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 or LASIK. Some of the Extended Range IOLs also have toric versions.
You and your cataract surgeon will discuss which lens is best for your lifestyle and your eye condition during your office surgical evaluation.
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.