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Your Guide to Cataract Surgery
Cataract surgery is one of the most common eye surgeries performed in the United States every year. We certainly perform more than our fair share here at Woolfson Eye Institute.
In fact, we offer cataract surgery in Atlanta (Sandy Springs and College Park, GA), Cumming (GA), Lawrenceville (GA), Douglasville (GA), Canton (GA), Snellville (GA) and Asheville (NC).
Join us as we talk about cataracts — signs & symptoms, treatments, types of surgery & lens options, and the entire patient care process from initial consultation to post-operatve care.
Explanation of normal vision and overview of cataracts
What are cataracts?
According to Prevent Blindness America, there are 22 million Americans over the age of 40 who have cataracts, and that number is expected to grow to over 30 million in the next five years. The problem certainly isn’t going away any time soon.
If you ask most people what a cataract is, the answer would be something like “a cloudy or hazy film that forms over the eye.” However, in actuality a cataract is when the natural lens inside your eye becomes cloudy.
In essence, protein deposits come together to create a “smudge” on the lens of your eye, much like a smudge on the lens of the camera. Unfortunately, you can’t just take a rag and some cleaner to get the smudge out of the lens of your eye (that would be a very bad idea!)
- Clouded vision caused by cataracts can make it more difficult to read, drive a car — especially at night — or see the expression on a friend’s face.
- When the lens of the eye is cloudy, it cannot focus light correctly on the retina, which can lead to a decline or loss in vision, and cause a variety of visual disturbances.
- Most cataracts develop slowly and don’t disturb your eyesight early on. With time, however, cataracts will eventually interfere with your vision.
Stronger lighting and eyeglasses can help you deal with cataracts at first, but when impaired vision begins to interfere with your usual activities, you might need cataract surgery.
For many patients, the first signs of a cataract are visual disturbances. These can include any or all of the following:
- Blurred or cloudy vision
- Loss of vibrancy, or changes in the way you see color
- Problems driving at night due to glare from headlights or road signs
- A phenomenon known as “second sight” where distance vision gets worse, but reading glasses are no longer required
- Dramatic, sudden changes in your glasses or contact lens prescription
If you are experiencing any of these issues, and think that your vision is being affected by a cataract or other eye problem, please contact the Woolfson Eye Institute location nearest you to schedule your evaluation.
For some patients with mild cataracts, a change in prescription can improve vision, but this is just a temporary solution to a problem that will not go away on its own.
There’s only one way to fix cataracts — remove the entire cloudy lens from the eye.
Every time we remove the cloudy lens, we replace it with an implant. The implant can have any number of features or technology associated with it, and we can assign any prescription to that lens implant that we want. But you have to go from a natural lens to a synthetic lens.
The primary treatment for patients who are affected by cataracts is surgery. Cataracts can be removed in a traditional manner using typical surgical tools or we use a laser to facilitate removal of the cataract (known as laser cataract surgery). During the procedure, the old, cloudy lens is removed and a new, artificial lens is put in its place.
The cataract surgery process
Whether you have a cataract in one eye or in both eyes, surgery is typically only performed on one eye at a time so that a patient is not trying to recover from surgery in both eyes at the same time.
Cataract surgery, whether done manually or with a laser, is a relatively straightforward, simple procedure that can have a profound effect on your vision, and of course, your overall quality of life.
You’ll want to start by allotting roughly 2-3 hours of your time for the surgery. The actual surgery takes only minutes, but additional time is required for preparation and recovery after the surgery.
Also, you want to make sure that you arrange transportation to and from your cataract surgery appointment, as you do not need to be driving immediately after surgery.
Preparation for cataract surgery involves a mild sedative, anesthetic or numbing drops that can make some patients feel a bit groggy. Once a patient is in the operating room, the skin around the eye will be cleaned with a disinfectant wipe, and special eye drops that dilate the pupil and prevent infection will be applied.
The first part of the procedure involves removing the old lens through a process called phacoemulsification.
In laymen’s terms, a device roughly the size of a pen tip is inserted through the cornea. Using high frequency sound waves, the cataract is broken up into small fragments that are immediately suctioned away.
This process clears the way for a new lens to be inserted, which will restore your vision and get rid of the cloudy vision you have been experiencing.
After the natural lens is removed, an intraocular lens (IOL) is inserted through the incision in the cornea using an injector tool. The lens is inserted right where the natural cataract lens used to be.
Slight adjustments are typically made to align the lens with the patient’s astigmatism (based on measurements taken before surgery), and at that point the lens is in place and ready to go.
Patients may experience a feeling of pressure on the eye, but most patients do not describe the experience as painful or unpleasant in any way.
Our goal is to match each patient with the procedure that is best for them and to minimize the risk of any complications. The side effects of cataract surgery are minimal, but may include the worsening of dry eye for a few weeks or even months following your cataract surgery procedure.
The dry eye is usually temporary, and goes away after a period of time. At Woolfson Eye Institute, we send all of our patients home with drops to help alleviate any discomfort associated with dry eye.
If you have any questions or concerns, you can always call our practice or schedule an appointment with your post-op care doctor.
As always, it is important to still see your eye care professional periodically for a routine exam and checkup. Just because you now have clear vision doesn’t mean you can stop going to the eye doctor!
Laser Cataract Surgery
Who is a candidate for laser cataract surgery?
Cataract surgery is performed to remove the cloudy natural lens from the eye, and is typically performed on patients between the ages of 60-75; however this is not always the case.
In most cases a permanent refractive intraocular lens (IOL) implant is inserted to replace the natural lens thereby restoring focusing power. Your surgeon will work with you to decide when to have cataract surgery, based on how well you are able to see during routine activities.
Many patients are able to drive, watch TV and work for a number of years after being first diagnosed with cataracts. However, if you have cataracts, you will eventually start to notice declining visual clarity – often with ghost images – which are not correctable with glasses or contacts.
You and your Woolfson surgeon will initially have a consultation to design your customized laser cataract surgery driven by your current health, medical history, and unique needs.
During this process, a detailed examination will be performed. Ask your surgeon if you should continue your usual medications and nutritional supplements during the period between the exam and surgery.
As just one example, common drugs that treat men with enlarged prostates known as Alpha Blockers may cause problems associated with Intraoperative Floppy Iris Syndrome (IFIS) during cataract surgery.
- Woolfson Eye Institute eye cataracts surgeons may present to you a choice of implantation with a regular single-vision (monofocal intraocular lens IOL) or a presbyopia-correcting intraocular lens (also known as a multifocal lens).
- If you are interested in correcting presbyopia, which all people begin to face around age 40, you potentially could restore your ability to see at all distances with a multifocal IOL.
- Additionally, premium IOLs are a great option that may reduce or eliminate your dependency on eyeglasses altogether. Before surgery, your eyes will be thoroughly measured to determine the proper power of the intraocular lens in addition to the types of lenses that are recommended.
The femtosecond laser cataract surgery process
Laser cataract surgery is a relatively new procedure in the United States that allows cataract surgery to be performed with a machine-guided bladeless laser, as opposed to standard or conventional cataract surgery that is performed manually by a cataract surgeon.
During the process, the laser will create corneal incisions as well as the capsulorhexis, and can also be used to break up the cataract before the natural lens is removed from the eye.
- Laser assisted cataract surgery has been shown to be superior to a manual instrument by significantly reducing the likelihood of human error when creating the capsulorhexis, as well as creating astigmatism treating incisions (LRIs) that are more accurate.
- With the ability to perform bladeless laser refractive cataract surgery, we are now able to provide a more precise, laser guided surgery for patients in need of cataract treatment.
- The result is a more predictable outcome for our patients. Laser cataract surgery is approved by the FDA, receiving its most recent approval in 2012.
Having laser cataract surgery at Woolfson Eye Institute is one of the best decisions you will make and will allow your procedure to be performed in our state-of-the-art Ambulatory Surgery Center (ASC) that was designed, developed, and built with your complete comfort and satisfaction in mind.
Currently, only patients that opt for premium lens implants such as multifocal IOLs, or those that are undergoing astigmatism correction in conjunction with their surgery, will qualify for FLACS.
Our doctors will discuss which treatment is best for you, and discuss all insurance regulations so that you can make an informed decision on the specific procedure that is right for you.
Achieve Custom Vision with the Light Adjustable Lens™ (LAL) from RxSight®
Now you have the option to optimize your vision after cataract surgery, thanks to the Light Adjustable Lens™ (LAL) from RxSight®.
Made out of a specialized lens material, it is the first FDA-approved intraocular lens (IOL) that allows our eye doctors to enhance and adjust your vision after your eyes heal from cataract surgery (approximately 2-3 weeks after cataract surgery).
That means, if you have any remaining vision problems after cataract surgery, such as hyperopia, astigmatism or myopia, LAL can give you the best vision possible.
Customized vision is achieved with a proprietary light treatment using a Light Delivery Device (LDD) that reshapes the implanted lens according to your custom prescription.
A total of 3 to 5 light treatments (each lasting approximately 90 seconds) is typically needed to achieve your desired vision. In between those 3 to 5 appointments, you’ll need to wear UV protective glasses to block UV light (we don’t want unnecessary/uncontrolled changes to the lens).
Once your optimal vision has been achieved with the light treatments, the lens power is permanently locked in using one final light treatment in order to prevent any additional changes.
The light treatments are:
- Fast (approximately 90 seconds per eye for each light treatment)
If you’re interested in LAL options, contact Woolfson Eye Institute to schedule your appointment today.
Our Eye Doctors who specialize in the Light Adjustable Lens
We offer the LAL option at the following offices:
Cataract Surgery: Fixed and Adjustable Lenses
How Does Light Adjustable Lens™ (LAL) Work?
Mutlifocal IOLs: Another Option for Cataract Surgery
What are multifocal IOLs?
Multifocal IOLs are premium lenses that can fix a variety of vision issues above and beyond traditional IOLs.
Long gone are the days of patients having only one option for an intraocular lens implant for their cataract surgery.
Now, there are a wide variety of IOL options on the market, and many patients are choosing multifocal IOLs over traditional “standard” or monofocal IOLs.
Traditional cataract surgery has been performed with the primary goal of restoring a patient’s vision far away, so that they can drive without blurred vision, see clearly from far away, and enjoy other activities where clear vision at a distance is required.
However, with a standard IOL lens a patient would still need to wear reading glasses or bifocal lenses after surgery to correct a problem that every patient will face: presbyopia (farsightedness).
- In effect, multifocal IOLs can correct presbyopia, and are similar to bifocal or multifocal contact lenses, with the exception that they are permanently implanted inside the eye, and do not require any care or routine maintenance beyond normal appointments with your eye care professional.
- You can think of a multifocal IOL as a lens that is implanted inside the eye to help you see clearly at any distance, and often without the need of glasses.
Which IOL is right for you?
Benefits of multifocal IOL lens vs. a standard IOL?
“Standard” or monofocal IOLs are great for providing clear vision at a distance, but patients will still need. However, patients will still need reading glasses to see clearly up close.
However, with multifocal IOLs that can treat presbyopia and astigmatism, patients are usually able to see well up close, at intermediate distances, and far away.
If there is a lens technology available that allows you to see clearly at any distance, and potentially get rid of your glasses or contact lenses, why wouldn’t you be interested in seeing if this particular treatment is right for you?
More details about multifocal IOLs
Common eye problems fixed with IOLs
Medicare or private insurance will generally cover the cost of cataract surgery (although it’s important that you check with your provider); however most of the time you’ll have to pay the extra costs associated with multifocal or advanced technology IOLs out of pocket.
Still, there are payment options that can help take the sting out of the extra costs. At Woolfson Eye Institute we offer payment plans and financing options such as CareCredit, and can provide a variety of options to help you pay for your multifocal IOLs.
While we understand that cost is certainly a factor when determining whether or not a multifocal IOL is right for you, it’s also crucial to look at the potential benefits of these lenses as well, as your quality of life can be greatly improved, and you can save money in the long run.
Multifocal IOLs are designed to deliver excellent vision over a range of distances and could reduce your need for glasses.
Please keep the following in mind:
- Do not evaluate your vision until you have had surgery in both eyes. It is very difficult for your brain to accept the difference in the vision between your two eyes until they can work together and adjust to your new vision.
- You are likely to see some glare and halos around lights after surgery. This usually improves within a few months.
- Typically, best reading will be achieved in high light conditions. You will likely need reading glasses in dim light.
- Your range of vision should be good and with time will adjust. Have patience.
- You may still need glasses after surgery, but you should need them less for most daily activities.
Interested in multifocal IOLs, or cataract surgery? Contact us!
If you are interested in laser cataract surgery or multifocal IOLs in Atlanta (Sandy Springs and College Park, GA), Cumming (GA), Lawrenceville (GA), Douglasville (GA), Canton (GA), Snellville (GA) and Asheville (NC), then please contact us today!
Our experienced eye surgeons are here to ensure that you get the treatment that is best for you.
During your initial evaluation, we’ll go over laser cataract surgery, as well as any other appropriate treatment options you may need to consider based on the health of your eyes and medical history.
Don’t wait. If you are ready to see clearly and eliminate your cataracts once and for all, then call the office nearest you today!