Cataracts and Cataract Surgery

What is a Cataract?

A cataract is clouding of the normally clear, transparent lens of the eye. As one ages, chemical changes occur in the lens that make it less transparent. When the lens gets cloudy enough to obstruct vision to any significant degree, it is called a cataract. There are no glasses, contact lenses or medicines to improve vision when a cataract is present.

The most common cause of cataract is aging. Other causes include trauma, inflammation, medications such as steroids, systemic diseases such as diabetes, and prolonged exposure to ultraviolet light. Occasionally, babies are born with a cataract.

The typical symptom of cataract formation is a slow, progressive, and painless decrease in vision. Other changes include blurring of vision, glare particularly at night, frequent eyeglass prescription change, decrease in color intensity, yellowing of images, and double vision in rare cases. Some types of cataracts affect distance vision more than reading vision. Others affect reading vision more than distance vision.

Reducing the amount of ultraviolet light exposure by wearing a wide-brim hat and sunglasses may reduce your long-term risk for developing a cataract; however, once developed, there is no cure except for surgical removal of the cataract. The time to have the surgical procedure is when your vision is bad enough that it interferes with your lifestyle.

Cataract surgery is a very successful operation. One and a half million people have this procedure every year and over 95% have a successful result. As with any surgical procedure, complications can occur during or after surgery and some are severe enough to limit vision. But in most cases, cataract surgery greatly improves both vision and quality of life.

Cataract Surgery

How does Dr. Kim remove a cataract? 
Dr. Kim uses topical (surface) anesthesia while the anesthesiologist administers intravenous sedation. There are no injections around the eye with topical anesthesia, avoiding the danger of bleeding, especially in people on any type of blood thinner. The gentle intravenous medication induces mild drowsiness, and many people do not remember the surgery, which usually lasts
15–30 minutes.

Dr. Kim removes cataracts with a technique called phacoemulsification. This technique uses ultrasound waves to liquefy the cataract. The entire procedure is performed through a 2.75mm incision—about half the width of a pencil. If the incision is beveled properly, it is self-sealing in large majority of cases and will not require any stitches.


At the time of surgery, the cataract is replaced with an intraocular plastic prescription lens implant that provides the appropriate focusing power. The new lens that replaces the cataract is made of foldable material that is inserted through the 2.75mm incision. Since it is prescription-adjusted to your eye, it can be chosen to eliminate preexisting nearsightedness (myopia) or farsightedness (hyperopia) as appropriate. With standard monofocal intraocular lens (IOLs), they focus only at one range, usually distant. You may need glasses after the surgery if you have astigmatism, and will likely need glasses or bifocals for some near vision. Your visual needs will be discussed before the surgery so that the proper lens implant can be chosen to meet your expectations.

After surgery the eye is shielded, but not patched for the trip home. You start eye drops the afternoon following your surgery, and continue for several weeks. Dr. Kim will see you the day after the surgery, and subsequently to monitor the healing of your eye.

There are exciting options available now for improvement in both distance and near vision with a new generation of lens implants: presbyopia correction cataract lens implants, also known as multifocal intraocular lens (IOLs). These implant lenses have been designed to provide you with clear vision, near through distance, with decreased dependence on reading glasses or bifocals.

 

Is there much pain?

Most people report a sensation similar to an eyelash in the eye for the first several hours following surgery, and are better by the next morning. Dr. Kim does not routinely give a prescription for any pain medication after cataract surgery.

 

How long am I in the hospital?

Two to three hours in the outpatient surgery center is typical.

 

When will I see better?

Color vision is usually noticeably better the first evening, and many people will see well enough to drive by the first week. If you need glasses, they are prescribed four to five weeks after your surgery. Some medical insurance pays in part for new prescription eyewear following cataract surgery.

 

When should the cataract surgery be done?


Cataract surgery is recommended when your visual function demands it. When you find that you are giving up things you enjoy because of decreased vision or if you are having any safety issues, you may feel the time is right.

 

When can the other eye be done?

The second eye is recommended for cataract surgery when your visual function demands it. Necessity varies for each individual. Some people feel unbalanced with only one cataract removed. Others happily go years between eye surgeries.

Presbyopia Correcting Cataract Lens Implants: Multifocal IOLs

Over time, the lens and muscles of the eye lose some strength and flexibility needed to focus on near objects. This normal aging process is called presbyopia and nearly everyone develops some degree of prebyopia after the age of 40.

Conventional lens implants are monofocal IOLs and they have been used for several decades. Monofocal implants only focus at one distance range. They can be set to provide best corrected vision at near, intermediate or far distance. Most people who choose monofocal implants have their IOLs set for distance vision and use reading glasses for near vision.

Recent advanced in cataract lens implant technology have made it possible to experience life without reading glasses or bifocals after cataract surgery. Lens implants are now available that allow focusing power at multiple viewing distances. These IOLs are called prebyopia correcting cataract lens implants or multifocal IOLs. With these lens implants, vision can be clear at distance and near without the use of glasses. For people who desire freedom from glasses after cataract surgery, the multifocal IOLs may be a possible option. There are several different types of multifocal implants, and we have chosen AcrySof® IQ ReSTOR® as the prebyopia correcting cataract lens implant that will offer our patients the highest quality of vision.

Contact us at Polaris Eye & Laser, Inc. to learn more about these exciting new lens implants options.

The AcrySof® IQ ReSTOR® intraocular lens (IOLs) draws upon decades of expertise and technology for IOLs. These implants significantly reduce or even eliminate the need for glasses after cataract surgery. It provides clear vision without the need for reading glasses or bifocals after the surgery.

Unlike monofocal IOLs that can only focus at one distance, the AcrySof® IQ ReSTOR® IOL is a multifocal lens. Its surface looks like a series of circular steps, thicker in the center and thinner on the edges. Each level focuses light from a different range, from near in the center to distant on the edges. They combine to give the patient a full range of vision without corrective glasses.

In a clinical trial, after having the AcrySof® IQ ReSTOR® IOL implanted in both eyes, at 6 months after cataract surgery, 78% of patients reported not needing glasses. Nearly 94 percent of patients indicated that they would have the lenses implanted again, according to a patient satisfaction survey.

AcrySof® Toric Lens Implants for Correction of Cataract and Astigmatism
Current technology makes it possible to correct the cataracts that may be clouding your vision and the astigmatism that may be distorting your vision all at the same time.

 

What is Astigmatism?


Astigmatism is a type of refractive error of the eye. It occurs when the surface of the cornea is not perfectly round. One side of the curve is steeper than the other, like a football. This causes light to focus at more than one point in the back of the eye, causing blurred vision. Glasses and contact lenses are generally used to correct astigmatism. A person who has both cataracts and corneal astigmatism will still need glasses to regain high quality of distance vision after cataract surgery. However, if corneal astigmatism is corrected at the time of the cataract surgery, a person could be free of glasses for distance vision.

 

What is AcrySof® Toric IOL?


AcrySof® Toric intraocular lens (IOL) is specially designed to correct astigmatism, as well as near or farsightedness, for cataract patients. In addition to restoring vision that was clouded by cataract, it also has the ability to reduce or eliminate corneal astigmatism at the same time. The result is normally less dependence on glasses and improved distance vision. Most patients will still need corrective glasses for near and intermediate tasks.

Visit Polaris Eye & Laser, Inc., to find out which cataract lens choice is right for you. Dr. Kim will explain your options for surgery and determine if you are a candidate for premium lenses during your evaluation. Contact us today.

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