A cataract is clouding that develops in the lens of the eye, reducing vision and the ability to complete everyday activities like reading, driving and seeing at distance. Cataracts often develop as a normal age-related change of the eye, slowly becoming worse as time passes. Other ways a cataract can develop include certain medications, like steroid eye drops and oral steroid pills; systemic diseases, like diabetes and autoimmune diseases; trauma to the eye, retinal surgery, hereditary cataract and congenital lens defects. Essentially any process that causes damage or inflammation to the lens or the eye will often result in a cataract.
As a cataract develops, patients often notice a decrease in vision at distance, trouble following a golf ball, difficulty reading in dim light, and reduced ability to drive; especially when oncoming headlights at night create glare and/or “starbursts” in their vision.
When a cataract is suspected, the staff and surgeons at Cornea and Cataract Consultants will use the latest precise diagnostic tools and exam techniques to ensure the decrease in vision is related to a cataract and not to another ocular problem. Once a cataract is identified a comprehensive conversation covering the cataract diagnosis, treatment options and follow-up will be undertaken.
At times when a mild to moderate cataract is found, a change in glasses or contacts can be used to adequately correct vision without the need for surgery. Eventually, however, surgery is usually required to remove the cataract and clear the vision.
How is cataract surgery performed?
Cataracts are surgically removed in an outpatient operating room under monitored anesthesia. This type of anesthesia means a patient is kept in a “twilight” or “dreamy” state by intravenous anesthetics. Topical anesthetics numb the eye, and an eyelid retractor is placed to keep the eyelids open at all times. Cataract removal takes approximately 10-15 minutes. The surgeon makes a small self-sealing incision in the eye and removes the cloudy part of the lens by dividing it into smaller pieces with an ultra-sound probe and removing them from the eye. The clear capsular bag that held the patient’s original lens is preserved as the place for a new, man-made lens implant. Antibiotic drops and anti-inflammatory drops are used to prevent both infection and inflammation of the eye for a month following surgery.
Recovery may take up to 2 weeks, but many patients see well in the first several days after surgery. Heavy lifting, bending, straining and rubbing of the eye is discouraged immediately following surgery. One eye at a time is operated upon, but the second eye may be scheduled as quickly as 1 week after the first.
Are there different options for vision correction during cataract surgery?
There are several choices for a patient when deciding to have cataract surgery.
The new man-made lens is available in three options. A standard (monofocal) lens helps patients see well far away, but reading glasses will still be needed. Astigmatism correcting lenses (Toric lenses) are available to reduce the blur of astigmatism. Reading glasses are needed for this type of lens as well. And, there are replacement lenses that help patient see well far away and up close (multi-focal), reducing the need for reading glasses.
Lastly, instead of using only the ultra-sound probe for lens removal, laser-assisted cataract surgery using the LenSx femtosecond laser can be performed, offering precise incisions of the cornea and astigmatism-reducing incisions as well.
The vast majority of cataract removal surgeries go smoothly and painlessly, with patients surprised and excited with the improvement in their sight, resumption of vision dependent activities and ability to remain active and independent.