What is a Cataract?

The clarity of your vision often depends on the eye's ability to focus light rays onto the retina (the light sensitive lining of the eye). As light enters the eye, ideally, the cornea and lens will bend and focus the rays onto the retina. The retina then sends an impulse to the brain by way of the optic nerve. The brain interprets this impulse and forms an image. Any abnormality of this visual pathway, from the cornea to the brain, will result in either partial or total loss of vision.
		A cataract is a clouding of the normally crystal clear lens of the eye. As the cloudiness increases, fewer light rays are able to penetrate the lens. Hence, vision becomes increasingly dim. Cataracts are generally a part of the normal aging process. As you become older, you have reason to suspect the development of cataracts when a change in vision is noticed. Some people complain that there is a film or fog over their eye and notice glare in bright light. As the cloudiness increases, vision decreases.

This condition cannot be totally corrected with medicine or glasses. If the cataract continues to grow, vision can be completely blocked, causing blindness. Also, when cataracts become dense or advanced, they may cause other eye conditions such as inflammation or glaucoma (elevated fluid pressure in the eye).

When should you have cataract surgery?

Cataract surgery is recommended when you have difficulty performing your daily activities or doing things you enjoy. Advancements in ophthalmic technology have made cataract surgery one of the most successful forms of surgery performed today. Ninety-five percent of the patients who have had cataract surgery enjoy excellent vision.

Is surgery necessary?

Surgery is the only effective treatment for cataracts. It is a relatively painless procedure which requires only a few hours in our Ambulatory Surgical Center or the hospital. Cataracts cannot be eliminated by medicine, a change in diet, or eye drops. Although laser therapy is used for other forms of eye treatment, lasers cannot remove cataracts. Several surgical techniques are used today in the treatment of cataracts. The most common procedure used during the last 10 years is called extracapsular cataract extraction. This procedure usually involves a 10mm incision and requires several stitches. Currently, a new method, called one stitch/small incision surgery, or phacoemulsification, is being used by some surgeons. A small incision, one-third the size of a traditional incision, is made under the upper lid. Through this incision, the doctor places an instrument called a phacoemulsifier, which uses sound waves to break up the cataract and remove the particles from the eye. The outer bag, or capsule of the lens, is left intact in the eye. Once a cataract is removed, a replacement lens must be provided.

Cataract glasses, contact lenses, and intraocular lens implants are all methods of lens replacement. The preferred method is the intraocular lens implant, which is inserted into the capsule of the lens at the time of the surgery. This capsule also produces a barrier between the front and back of the eye, reducing the possibility of future complications. Small incision surgery also means that fewer stitches are needed. This technique not only decreases the time it takes for the eye to heal, but also reduces irregularities of the surface of the eye (astigmatism).

A relatively new innovation is the use of no-stitch cataract surgery. With this type of surgery, a small incision is used, but is placed away from the iris (the colored part of the eye). A tunnel is created from the incision to the iris. The cataract is removed and the implant placed into the eye through this tunnel. The tunnel is self-sealing, and therefore does not require a stitch. Since stitches can cause astigmatism, no-stitch surgery decreases the risk of this unwanted problem. Additionally, patients may be more comfortable after surgery because there are no stitches to cause irritation.

Methods to Correct Vision After Cataract Surgery

Intraocular Lenses:

Intraocular lens implants are the preferred method of lens replacement today. They cause little or no visual distortion and patients do not have the inconvenience of handling or cleaning the lens. The lens implant remains permanently inside the eye, in the same position as the natural lens. With intraocular lens implants, patients are not hindered by poor vision as they attempt to look through cataract glasses or insert contact lenses. Although normal thickness glasses may be required over the lens implant to provide the clearest distance and near vision, most patients simply open their eyes each morning and enjoy the benefits of clear vision.

Prior to surgery, the patient is scheduled for presurgical testing. A complete eye evaluation is performed, followed by specific diagnostic testing, to help insure the best possible surgical results. Although cataract surgery is a very delicate microsurgical operation for the surgeon, it is a relatively short and easy procedure for the patient.

Our surgeons are all highly trained and have had extensive experience with the most up-to-date techniques to remove the cloudy cataract. Florida Eye Clinic's Ambulatory Surgical Center offers a relaxed and friendly setting for the patient and the patient's family. Shortly after surgery is completed, the patient may go home and resume almost all routine activities immediately. It must be understood that complications may occur in all types of surgery. In cataract surgery, hemorrhage, infection, and swelling are all possible, but very uncommon. The chance of any significant complication is less than 5%.

Cataract surgery is among the safest and most successful procedure in the medical field. However, if a problem does arise, prompt treatment may resolve it. Each year, approximately 10% of the patients who undergo extracapsular cataract surgery develop a haze of the capsular membrane surrounding the lens implant. Should this occur, YAG laser surgery is an exciting advancement in medical treatment. The YAG laser is used to create an opening in the clouded membrane, which significantly improves the patient's vision. It is the safest treatment used surgically in ophthalmology. It is painless, requires no anesthesia or incision, and takes only minutes to complete.

Information about Intraocular lens implants:

• Gives full side vision
• Requires no patient handling
• Provides no magnification (normal size images and vision)
• Is not felt by patient (it is inside the eye forever) and cannot be lost
• Is useful in dusty environment
• Does not require daily removal by patient
• Provides the most natural vision after surgery
• Is usually placed in the eye at the time of surgery, yet may be implanted after surgery in selected patients
• Has been used since 1958
• Is not for all patients (certain general diseases and eye pathology preclude implants)