Cataract surgery is a commonly performed eye procedure, in the United States. There are various reasons and various ages for developing cataracts; however, the typical age range is between 65 to 75. The rise in numbers with cataract surgery is a direct correlation to the rising growth of the Baby Boomer generation. Cataracts are inevitable as it is the gradual progression of aging in the natural eye lens.
Cataract surgery has come a long way since the days of inpatient surgical procedures in hospitals, patching the eyes and patients bedridden for a week to facilitate healing. Growing in popularity is laser-assisted cataract surgery, with no needles, no eye patching, in an outpatient surgical setting. Laser-assisted cataract surgery reduces human error allowing for greater precision, and reproducibility in surgical results. Patients return to the office for their 1-day post-operative appointment following surgery and usually resume regular activity within a few days to a week protecting the site of surgery and keeping the area clean to avoid infection.
About Cataracts & Cataract Removal
Cataracts are the most common cause of blindness in the world. Fortunately, cataracts are reversible by cataract surgery. Cataract surgery is the most commonly performed procedure in the United States. Most patients in the United States seek help when they notice a decrease in their visual quality during routine activities like driving at night or reading the fine print. The colors may start to fade and it may be difficult to differentiate some colors in dim lights like black and navy blue. Millions of cataract surgeries are performed annually to help patients see better. Cataract surgery entails removing the cloudy part of the crystalline lens of the eye and inserting an intraocular lens replacement. The intraocular lens replacement can be customized to the individual eye to help the patient achieve visual freedom. There are many intraocular lens technologies available to patients including mono-focal lenses that have one focus; either distance or close-up and do not correct for astigmatism. These patients will achieve improvement in the quality of vision, but will probably require a pair of glasses post-operatively. Toric intraocular lenses will correct for astigmatism, and they come in single-focus or multifocal options. The single-focus toric lens will achieve distance or near vision correction or blended (mono) vision, where one eye is focused at distance, the other eye is focused on close-up, and the brain merges the images achieving the ability to see both distance and close-up. Multifocal intraocular lenses in toric and non-toric versions will help the patient see distance and close-up out of each eye in both eyes. The latest advancement in intraocular lens technology is the light-adjustable lens. The light-adjustable lens can be adjusted with a specific wavelength in the ultraviolet light spectrum to modify the shape of the lens, thus changing the power of the lens. This allows for fine-tuning of the prescription of the eye post-operatively to the needs and satisfaction of the patient.
How Does Cataract Surgery Work?
Modern cataract surgery is an outpatient procedure commonly performed in an ambulatory surgery center or an in-office certified surgical suite. Modern procedures are also performed under topical anesthesia. Intravenous or oral sedation is used to help the patient be comfortable during the procedure. The procedure is quick and takes about 10 minutes. It is painless and typically has a painless postoperative course. Cataract surgery can be either performed manually or assisted by the femtosecond laser. During the manual procedure, the surgeon performs all aspects of the procedure. The cloudy portion of the crystalline lens is broken down by an ultrasound probe in a process called phacoemulsification. Femtosecond-assisted laser cataract surgery has the added advantage of precision, accuracy, and repeatability as the laser is driven by a highly advanced computerized algorithm it delivers the different aspects of the treatment plan. The femtosecond laser will also treat astigmatism thus refining the glasses-free visual acuity by creating limbal relaxing incisions or by precisely aligning the axis of the toric intraocular lens that corrects astigmatism. The Lensar femtosecond laser helps the accurate centration of the intraocular lens based on the optical or pupillary axis of the eye. It also utilizes iris recognition technology to ensure that the treatment is centered and aligned to where all the preoperative measurements were taken in the upright head position.
What is the Recovery Like For Cataract Surgery?
Patients will usually be discharged after a brief check in the recovery area in protective goggles. They are instructed to use medicated drops to the operated eye and to follow up in the office either the next day or the same day of surgery. Recovery from cataract surgery is usually quick in most patients. Although most patients can see well the next day, some may be still blurry especially if they had a more advanced cataract preoperatively. The pupil may also still be dilated the next day. Most patients see rapid visual improvement daily and can resume daily activities within days.
What is the Process for Cataract Removal at San Antonio Eye Specialists?
1) Patient experiences a reduction in the clarity of vision and brightness of colors. Night driving may be difficult and patients may experience glare with oncoming car lights and street lights.
2) Patient schedules a cataract evaluation with an eye specialist in which the patient is dilated to examine the overall health of the eye and several diagnostic tests are performed to assess the progression of the cataract. Surgery is deemed necessary for the more advanced cataract first if both eyes need surgery. Surgery is performed one eye at a time.
3) At San Antonio Eye Specialists, all patients scheduled for a cataract evaluation meet our refractive surgeon, Dr. Iskander, and he determines a customized surgical treatment plan. Dr. Iskander discusses the various lens implant options based on the patient's lifestyle and visual needs. Patients also meet the surgical counselor to discuss surgery dates, insurance coverage, and payment options as well as eye drop schedule.
4) Laser-assisted cataract removal or traditional cataract surgery is an outpatient procedure performed at an ambulatory surgical center. Patients need a designated driver to bring them to and from the surgery facility as they will be sedated. Patients are expected to be fasting for surgery.
5) Following cataract removal, patients are encouraged to go home and sleep while taking care to protect the eye of any infection and follow the eye drop regimen following surgery.
6) All patients are seen the next day in the office for their 1-day post-operative appointment to measure eye pressure and vision.
7) Patients are seen again at their 1-week appointment to assess the continual improvement of vision and schedule the second eye for cataract surgery, if necessary, repeating steps 3-7.
Cataract removal is safe and life-changing, improving the quality and longevity of life that our Baby Boomers expect. Dr. Iskander looks forward to meeting you and discussing your visual options. Take advantage of his refractive surgical fellowship training and surgical expertise spanning over 20 years. For your eyes...Don't compromise!