Cataract Surgery
Surgical and Non-Surgical Options for Cataracts
What is a cataract?
A cataract is a clouding of the eye's natural lens, with consequent blurring, and degradation of vision. Most commonly, cataracts affect the senior population, though the condition may occasionally affect much younger people, and sometimes children.
Cataracts would be leading cause of blindness in the developed world, if not treated. Until the advent of laser vision correction, cataract surgery was the most common operation performed by eye doctors.
Cataract Surgery, and its' refractive companion, Clear Lensectomy describe procedures to remove the eye's natural lens and replace it with an Intra-Ocular Lens ("IOL," or "lens implant"). This surgery can correct extremely wide ranges of refractive error. Modern cataract surgery alone is not able to correct astigmatism as accurately as LASIK, but can be performed in combination with LASIK or a procedure called "limbal relaxing incisions" for astigmatism reduction.
What does cataract surgery involve?
Modern cataract surgery has become perhaps one of the safest and most predictably beneficial operations performed today. Typically, it is done on an outpatient basis under local or eyedrop anesthesia. In the hands of a capable surgeon, the process should take 15 minutes or less to complete. Vision recovery can be almost as rapid as with LASIK; many patients are able to see a sharp 20/20 the day after their care.
Small incision cataract surgery is done through an internally self-sealing incision about 1/8" wide. The yellowed, firm nuclear tissue is removed by breaking it into microscopic fragments with an ultrasonic instrument called a phacoemulsifier ("phaco" for short). The nuclear tissue is enveloped within a clear membranous sac called the lens capslue (also referred to as the "capsular bag"); modern surgery intends to preserve the delicate capsule while removing the nuclear contents within. The IOL is then implanted within the capsular bag. The lens capsule is connected to the ciliary muscle (focusing muscles of the eye) by tiny fibers called zonules, thus providing support in a fashion analogous to a hammock. Measurements made before surgery assure in most cases that distance glasses are not required after surgery.
Until very recently, artificial lenses implanted at the time of cataract surgery were all single-focus or fixed-focus lenses. So, even if distance vision could be rendered optimal with such care, reading glasses would still be necessary. It is self-evident that any patient who may contemplate cataract-style surgery would want to enjoy clear distance vision, clear reading vision, and clarity everywhere in between, without need to use glasses.
Significant challenges exist in designing a lens implant that can accommodate, or adjust for close focus. Such a lens will (if and/or when it can be developed) possibly revolutionize the treatment of cataracts, and may also offer a surgical treatment for presbyopia. As of early 2004, all the current treatment options offering surgical reversal of presbyopia are not yet "ready for prime time." With some good science, brilliant engineering and ingenuity, that situation may change in the not-too-distant future.
In May, 2003 the FDA approved a new design of implant called the "CrystaLens Model AT-45" manufactured by Eyeonics. This implant allows some acommodation or adjustment for close focus, and thus represents a revolution in design and performance of intraocular lenses. This lens is not a "perfect" replacement for the eye's natural lens; at best it can accommodate or adjust focus by about 1.75 diopters where the normal young eye has an accommodative capacity of 2.5 to 3.0 diopters. However, it can certainly allow improved distance, intermediate and near vision compared to previous lens designs. Reading glasses may still be necessary for sustained reading of small print.
ReStor® IOL (Intraocular Lens)
The AcrySof® ReSTOR® intraocular lens was designed to improve vision for cataract patients at all distances, giving cataract patients their best chance ever to live free of glasses and avoid surgery. Made by Alcon Surgical, one of the leading optics manufacturers in the United States for over 50 years, the ReSTOR® lens has been FDA-approved since March of 2005. AcrySof, the material used to make the ReSTOR IOL, has already been used in another IOL and implanted millions of times since the early 1990’s.
Read more about ReStor®
ReZoom™
The ReZoom™ intraocular lens is a second-generation refractive multifocal IOL that provides hyperopic cataract patients with greater independence from glasses than monofocal IOLs. The ReZoom™ IOL is indicated for the visual correction of aphakia in persons 60 years of age or older in whom a cataract has been removed, and who may benefit from useful near vision and increased spectacle independence across a range of distances.
More information about ReZoom™
|
Am I a LASIK Candidate? 
