A Primer on Cataract Surgery
Cataracts are one of the most prevalent medical conditions afflicting the American public today. It is estimated that roughly one in every fifty people, a total of five and a half million patients nationwide, suffers from cataracts today. Fortunately for these patients, recent advances in medical science and microsurgery have made cataract surgery one of the fastest and most successful medical operations available.
The first step in cataract surgery is to treat the eye with local anesthesia to minimize both pain and discomfort. After the eye and surrounding area have been numbed, a small incision is made in the cornea a special surgical instrument is inserted. This instrument emits ultra high-pitched sound waves (ultrasound) that break the cataract into segments that can be easily suctioned out of the eye cavity. Since this type of surgery uses no blades or lasers, there is little, if any, scar tissue to interfere with vision after the surgery and recovery.
After the cataract is successfully removed a prosthetic lens, called an Intraocular Lens Implant (ILI), is implanted. This synthetic lens can be inserted by means of the original incision through which the surgery occurred. After the surgery, there is a brief recovery period in which the patient is monitored to be sure there were no adverse reactions to the anesthesia and so that the surgeons can be sure the ILI is in its proper position. The recovery period is typically limited to a couple of hours, after which the patient is released to go home. There are no prescription drugs necessary following this surgery, however the doctor may prescribe eye drops to reduce irritation and dryness or a patch to prevent scratching. Following the brief recovery period and a customary follow-up appointment, patients will typically return to work or school within two to three days.
The Intraocular Lens Implants used in ultrasound cataract surgery can also be used to correct severe presbyopia. Presbyopia, Latin for “old eyes,” is a common condition that results from the changing chemical and crystalline structure of the eyes’ lenses due to advancing age. This change in composition causes the lens to lose the ability to flex, severely hampering a patient’s focusing capabilities and making it difficult to read and perform other daily activities that require the eyes to focus on objects at close distances. Presbyopia is a normal result of aging and affects nearly everyone over the age of forty, though it is most noticeable after the age of fifty-five.
In the past, patients were limited to monofocal lens implants in surgeries of this type. Monofocal implants are only effective at focusing light from one fixed distance, however, and patients were required to wear glasses to see effectively at any other distance. Recent advances in lens technology now allow patients to choose between several different types of multifocal lens implants. Multifocal implants like ReSTOR, ReZoom, and Crystalens allow patients to focus on objects at several different distances, making them more effective for driving, reading, and other daily activities. These new multifocal lenses have reduced the dependency on glasses following cataract surgery from 70% with monofocal lenses to only 15% on average.
As with any surgery, it is important to discuss any risks and advantages with your surgeon or doctor. Although ultrasound surgery for cataracts is much safer and more effective than techniques used in the past, it is not perfect and there are risks inherent. During the process of preparing for the procedure it is important to go over the patient’s daily routine and discuss with the surgical staff what kinds of activities are most important to the patient both personally and professionally. The information the surgeons obtain during this process will help them decide what are the best options as far as the surgery and Intraocular Lens Implant are concerned. It is also worth noting that the multifocal lens implants are more expensive and require more pre-operation tests than monofocal lenses. However, as previously discussed, the benefits of a multifocal lens are worth the extra effort and expense.