Cataract Treatments

Cataracts, Cataract Surgery, and Lens Implants

As we get older, cataracts become a problem experienced by a great number of people just like you. Cataracts are a common cause of vision problems among people in their 50s and 60s, and they are a major cause of senior eye problems and vision loss. More than 20 million Americans age 40 and older have cataracts and more than half of all Americans develop cataracts by age 80. A cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision. For many patients, cataracts start out slowly and have little effect on vision at first. But, as the cataract becomes denser, so does the impact on vision.

C​ataracts are caused mainly by age, trauma, heredity, and exposure to ultraviolet radiation. Cataracts can also occur as a result of eye disease, after the use of certain medications, or as a result of medical conditions such as diabetes.

Common causes of cataracts:

  • Getting older – Age is a major cause of developing cataracts
  • Birth defect like abnormal conditions in the eyes of unborn babies
  • Environmental factors such as disease, toxic chemicals, medications
  • Accidents or injuries
  • Exposure to ultraviolet light
  • Cigarette smoking

Cataract statistics

Cataracts are the result of the eye’s lens becoming tinted and cloudy. This accounts for over 48% of the world’s correctible blindness. Sooner or later cataracts affect just about everyone.

Studies show that cataracts affect:

42% of those between the ages of 52 to 64
60% of those between the ages of 65 and 74
91% of those between the ages of 75 and 85

Most people do not realize how much cataract surgery has advanced over the last 10 years. Not only have there been developments in the equipment but also with the lens implants themselves. Millions of people undergo cataract surgery every year and have successful surgeries.

When considering cataract surgery, you now have new options for lens implants. Some lenses can even correct your vision at near, far and intermediate distances. Years ago, the only lens implants were monofocal, now you have options for multifocal/accommodating lenses or the traditional monofocal lens implants. Be sure to discuss these options in your consultation and pre-operative eye exams.

Intraocular Lens Options

Intraocular lenses come in a variety of materials and designs. Your physician generally chooses a lens made of a material that is best suited to your individual situation. Some intraocular lenses used in our practice are coated with UV filters. These lenses are theoretically better at blocking the light rays in the blue spectrum. UV radiation is thought to be related to the development of macular degeneration in some patients. Some intraocular lenses are designed to be multifocal, which may enable patients to see both at distance and near without the aid of glasses. Additionally, we also offer accommodating lens implants, which actually move inside the eye to emulate the natural process of the eye’s crystalline lens.

Please contact any of our ophthalmology practice locations to book your appointment for a cataract consultation.

Symptoms of Cataracts

If a cataract is making it difficult for you to carry out your normal activities most doctors may suggest cataract surgery. Even if your visual acuity isn’t severely affected, you might want cataract surgery to remove a cataract that’s causing problems with glare or double vision.

Symptoms of cataracts include:

  • Painless, cloudy, blurry, or dim vision and a feeling that you might need a change of eyeglasses.
  • You may notice that it is not as easy to see well and comfortably in dim illumination, such as for night driving or reading.
  • You may notice that colors look faded or yellowed, and you may be bothered by glare, haloes, light sensitivity, and a continuing decrease in your vision.
  • You may need frequent changes in eyeglass or contact lens prescription.
  • You may experience double vision in one eye.

These are the visual symptoms that are common for those patients whose crystalline lens has clouded and formed a cataract.

If you are experiencing one of more of these symptoms, please be sure to let your eye doctor know at your eye exam. Book an eye exam today with one of our experienced ophthalmologists.

What is Cataract Surgery?

During cataract surgery, we remove the cataract and replace it with a clear permanent lens implant in order to correct your vision.

Among seniors and “baby boomers,” cataract surgery is one of the safest, most effective, predictable, and common operations performed in the U.S., with more than 2.5 million people having cataract surgery and lens implants each year.

Cataract surgery is one of the most common procedures performed in the world. It has a very high success rate, but we know that surgery can be scary and overwhelming for anyone. This is why at Tenafly Eye we constantly strive to achieve outstanding vision results for each patient by understanding their individual needs and making sure you are always comfortable. We offer the most advanced technologies available to help choose the most appropriate lens implant and treatment plan for you.

Please feel free to call or email us at any time for questions or concerns.

At Tenafly Eye we look forward to helping you see and live your best.

The Cataract Surgery Procedure

During cataract surgery

Preparation for your cataract operation will begin with a few sets of drops being placed in your eye to dilate your pupil. Additionally, your eye will be treated with anesthetic drops to numb the surface of your eye so that you will feel little if any discomfort during your cataract surgery. In addition, you will be given medicines to help you relax, if desired. The entire procedure usually takes less than 30 minutes and is not uncomfortable.

Modern day cataract surgery is routinely performed with small incision micro-surgery through a process known as phacoemulsification. The cataract removal and surgical process is actually done using the smallest possible incision, and removal of the lens material is accomplished using an ultrasonic probe.

Before a new man-made intraocular lens can be implanted, the hardened cataract needs to be removed. After the eye is cleaned and proper dilation of the pupil has been achieved the surgeon is ready to make the incision. A micro-incision about the size of 2 millimeters is created at the junction of the cornea and the white part of the eye known as the sclera. The lens capsule is then opened and the ultrasonic probe is inserted so that the cataract can be removed. The ultrasonic probe pulverizes the cataract and suctions out the cataract material.

After the cataract is removed the surgeon is ready to implant a man-made intraocular lens. This is a crucial point of understanding for patients. Patients can either have a monofocal lens which will only correct vision for one distance or they can opt to upgrade to a premium lens implant that can reduce or eliminate their need for glasses after cataract surgery. There is an additional cost to upgrade to premium IOLs, while traditional monofocal lenses are covered by Medicare and private insurance providers.

Recovering from cataract surgery

Patients are typically concerned about the cataract surgery recovery process. The doctors and staff at Tenefly Eye provide the best quality care and thoroughly explain what you can expect after cataract surgery.

Recovery from cataract surgery is generally very quick. Most patients obtain better vision within the first 24 hours of the procedure. Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, any moderate discomfort should disappear.

We will arrange to see you within 24 hours of your cataract and lens implant procedure, so we can examine you in order to confirm that you are healing and seeing as planned. The doctors will also prescribe some eye drops for you to use and will ask you to wear a protective shield, mainly at night, to remind you not to accidentally rub your eye. Although each patient will heal a little bit differently, the majority of patients having cataract surgery with the cataract surgeons at Tenefly Eye Associates, PA, are able to see well enough to return to their daily routine activities within a day or so after their operation.

 

Types of Lens Implants

During cataract surgery, the natural lens (the cataract) is removed and a new, synthetic lens or intra ocular lens (IOL) is implanted in its place. Thanks to advances in IOL technology, there are now more options available for you as you choose an IOL.

The standard IOL used in cataract surgery is called a monofocal IOL and it provides excellent vision for either distance or near, but not both. Most patients choose to correct their distance vision and then wear reading glasses for near work.

The newer, “premium IOLs” can decrease your dependence on glasses and in some cases, eliminate it. Our surgeons will first need to establish if you are a candidate for these IOLs.

In addition, there is no guarantee that you will be completely free of glasses for all activities after surgery with a premium IOL. However, for those patients who value the opportunity to be less dependent of their glasses, premium IOLs are often a good choice. It is important to know that there is an extra charge for these premium implants, which is not covered by Medicare or private insurances.

Type 1: The Basic Monofocal Lens Implant

The Basic Monofocal Lens Implant A basic intraocular lens is a fixed lens (it doesn’t move) that is designed to deliver improved vision at just one distance. The potential drawback is that after surgery you will probably need to wear glasses, even if you didn’t wear glasses before surgery. The advantage of the Basic Monofocal Lens is that it is covered by insurance plans.

Pros:

  • Excellent if you want to wear eyeglasses after surgery
  • Requires no period of adjustment
  • Covered by insurance

Cons:

  • Does not correct astigmatism
  • Does not correct presbyopia
  • At least 90% of patients have to wear eyeglasses, at least part of the time

Type 2: The Premium Lens Implants

There are two categories of premium lens surgery:

  • Astigmatism-Correcting Surgery
  • Presbyopia-Correcting Surgery

Category 1.  A Toric IOL is proven to have a clinically significant reduction in astigmatism as compared to a non-Toric IOL during cataract surgery in patients with astigmatism.

Category 2.  Presbyopia-Correcting IOLs (Accommodating and Multifocal) have been shown to reduce dependency on eyeglasses significantly, with slightly more than 90% of patients using eyeglasses either never or only occasionally. About 95% of patients indicate that if they had to do it over again, they would once again select a presbyopia-correcting IOL.

Astigmatism-Correcting Surgery (Toric Lens Implant)

accommodating lens implantIf you have been told that you have developing cataracts and you also have astigmatism, new premium lens implant options are available to help minimize your need for glasses after surgery. If you are unsure if have astigmatism please check with your eye doctor.

Astigmatism is a refractive error where people are unable to see objects clearly from a distance or up close. Astigmatism is asymmetric steepening of the cornea or natural lens causing light to be focused unevenly. Astigmatism may occur in varying degrees in each eye and can accompany myopia or hyperopia. For individuals with uncorrected astigmatism, images may look blurry or shadowed.
Toric Lens Implants are a unique type of lens implant that are used to correct astigmatism. A toric lens implant is NOT the only method of astigmatism correction, so consult a doctor about the current possibilities. Astigmatism is very common and can be corrected with glasses, contact lenses, corneal relaxing incisions, laser vision correction, and special implant lenses. If a cataract patient has astigmatism and has aspirations to be glasses-free after surgery, the Toric lens implant is a good option. Toric lens implants are NOT a correction option for presbyopia. The ACRYSOF® Toric lens implant is a popular choice for this type of lens.

Presbyopia-Correcting Surgery

Presbyopia Type 1 – The Accommodating Lens Implant
accommodating lens implantAn Accommodating Lens Implant not only treats your cataract but can also reduce your dependence on glasses. It does so by recreating accommodation similar to your eye’s natural lens. It can reduce or eliminate glasses for most activities, including reading a book, working on the computer, and driving a car.  An Accommodating Lens “flexes” within the eye using the eye’s natural muscles to focus on subjects at various distances, delivering a continuous range of vision: far, intermediate, and near.

Pros:

  • Provides seamless focusing from far to near
  • More than 90% of patients reduce their dependency on glasses

Cons:

  • Near vision depends on your eye’s ability to flex the lens
  • Scar tissue can prevent the lens from flexing
  • If you read for a long time your eye muscle may tire

Presbyopia Type 2 – The Multifocal Lens Implant
multi focal lens implantMultifocal Lens Implants are essentially tiny implantable bifocals. They are manufactured with very fine rings that divide the lens into multiple focus points so you can see well at a variety of distances. These are passive lenses, and do not require any muscular activity in your eye for focusing. From the moment you leave the operating room you have the ability to see both far and near.

Pros:

  • Does not depend on muscle activity for its effect
  • Will begin to work immediately
  • Compared to Accommodating lenses, they usually are more effective for very close work
  • More than 90% of patients reduce their dependency on glasses

Cons:

  • Glare and halos may make night driving difficult
  • It transmits far and near images simultaneously
  • You may have difficulty seeing an object against a dark background

AcrySof® ReSTOR® IOL

The ReSTOR® lens is a multifocal lens implant that is designed to replace the natural lens of the eye after cataract surgery. Comprised of a flexible plastic material, the ReSTOR® lens has a patented design that allows it to focus light on the retina for clear vision at near, far, and intermediate distances. The benefit for cataract surgery patients is a high level of spectacle freedom. Alcon has patented the application of apodization technology to an IOL, making the AcrySof® ReSTOR® lens the first apodized diffractive IOL.

How Does ReSTOR Work?

As we perform daily activities such as reading the newspaper, watching TV or working on the computer, our eyes are constantly changing focus through a process known as “accommodation”. This task is performed by the lens of the eye, which changes shape, or accommodates, to allow the eye to focus at different distances. However, as we age our lens loses the ability to change shape and thus our accommodating ability diminishes, causing us to become more dependent on bifocals or reading glasses. The AcrySof® ReSTOR® IOL by Alcon is a foldable IOL lens that was designed to overcome this dependence, helping correct for the condition known as presbyopia.

IOL Self-Test
Alcon LensX Laser

At Tenafly Eye Associates, we work hard to make sure
that the technology we offer our patients is current, state-of-the-art, and dependable. For this reason, we are happy to provide laser cataract surgery using the Alcon LensX Laser- the first femto second laser cleared for use in cataract surgery!

In traditional cataract surgery, your eye surgeon will typically use a metal blade, allowing for the creation of small incisions in the cornea. LensX laser technology allows for this to be done without the use of a blade and provides precise results in the removal of your cataracts. The LensX laser is additionally equipped with real-time diagnostic tools that provide visuals to your surgeon during your cataract surgery! The laser can be programmed to suit the needs of each individual patient, down to the degree, size, shape, and location of each incision. The LensX laser is reliable, predictable, and accurate.

Choosing the LensX laser system for your cataract surgery has many perks. Using the LensX laser, patients can expect the energy used for cataract removal to be reduced significantly as compared to traditional cataract surgery. Laser cataract surgery also has lower chances of complication, reduced recovery times, and results that will change your vision for the better and that will allow you to see life clearly.

Some patients are not candidates for laser cataract surgery. Prior to your surgery, you will need to consult your doctor in order to decide whether traditional or laser cataract removal is right for you. Our doctors at Tenafly Eye Associates are here to help you make the best choice for your eyes; feel free to request an appointment to discuss your cataract surgery, or, if you have questions, contact us today!