Cataracts
What is a cataract?
The term cataract refers to the clouding of the normally clear natural lens in the eye. In our youth, this lens easily changes shape and allows us to focus on objects near and far. As we grow older, the first changes that we experience involve an increasing difficulty with near vision. A stiffening of the lens limits our ability to focus on near objects. With time, the stiffer lens becomes cloudier, eventually limiting or distorting the amount of light that enters the eye. This is the normal progression of cataract formation that leads to a decrease in vision.
What can be done for cataracts?
Cataract development is the most common cause of reversible vision loss. Modern medical technology has made cataract surgery a safe and effective way to improve vision in over 95% of patients.
Microsurgical techniques are used to remove the cataract and replace it with a crystal clear lens implant. Two small incisions (only 1 to 3 millimeters in size) are typically used to introduce instruments into the eye. Ultrasound energy is used to break the cataract into small pieces. These pieces are then removed through a small tipped instrument. Once the cataract has been removed an artificial lens implant is placed in the eye, which approximates the power of the natural lens. Often the lens implant can take into account the need for distance or reading glasses. This procedure can be performed in minutes and is relatively painless.
How do I know if I have a cataract?
If you feel that your vision has deteriorated, to the point that reading, driving, or other daily activities have become difficult, then you may indeed have cataract formation. Your eye doctor can diagnose cataracts through a routine eye exam.
Do I need surgery?
If you are diagnosed with a cataract that does not mean you need surgery. Cataract formation occurs at different rates, affecting each eye differently. Some patients may be diagnosed with cataracts, but may not experience the same trouble seeing as other patients with cataracts. Your eye doctor can help you determine if cataracts are the cause of your vision problems, and if surgery can help improve your vision.
How long is my recovery?
With the newest advances in surgical techniques and instrumentation, recovery after cataract surgery has significantly improved. Not so many years ago, patients would be hospitalized for up to two weeks with head immobilization. Now the surgery requires an outpatient visit to an ambulatory surgery center, followed by a quick recovery. Vision improves shortly after surgery and full physical activity is recommended after a period of two weeks. Eye drops are the most common postoperative medication. These are used for approximately one month.
What about complications?
Cataract surgery is one of the safest and most effective surgeries performed. While success rates are very high (over 95%), there are rare instances where the vision is not improved and may even be diminished after surgery. Unsuccessful cases may occur after infection, inflammation, or bleeding. Certain eye conditions such as glaucoma, diabetes, and pseudo exfoliation may be predisposed to surgical difficulties. A second surgery may be necessary in these and other cases.
Will I need glasses after surgery?
Possibly. Many patients have undergone cataract surgery and enjoyed the benefit of not requiring glasses for distance or near vision. The implant that is inserted into the eye can take into account the power of prescription glasses worn. While very successful, it may not fully correct the distance vision to 20/20 without glasses, as in patients with astigmatism. Furthermore, while distance vision may be perfect, patients may need to wear reading glasses for near vision. Certain patients have done very well with monovision, where one eye is corrected for distance with the implant, and the other eye is corrected for near. Many options and outcomes are available. Your surgeon can review your exam findings and determine the likelihood of whether or not you will need glasses after surgery. It is likely that you will need glasses for only near, only distance, or both.
Cataract surgery has undergone a tremendous evolution. Technological advances have made an intricate procedure safe, predictable, and comfortable for our patients. Please feel free to contact your ophthalmologist regarding any questions you may have about your cataract surgery.
