The lens of the eye allows light to be focused on the retina in order to have good vision. As we age the lens becomes cloudy and, similar to having smudges on your glasses, the image gets blurry. When this occurs the cloudy lens is called a cataract. This can affect your daily activities such as driving or reading. The only way to improve or restore your vision when this occurs is to remove the cloudy lens and replace it with a clear artificial lens. This is done with cataract surgery—one of the most common and safest surgeries performed in the United States.
Cataract Symptoms and Signs
Cataracts usually develop slowly. When they initially start, most people do not notice the slight loss of vision. Some can lose a large amount of their vision prior to noticing the symptoms. In fact, when doctors remove the cataract in these patients they are often amazed at how much vision they were missing.
Cataracts can also cause other symptoms, such as significant glare and haloes. Patients often notice increased glare with oncoming headlights at night, which causes these patients to have difficulty driving safely. Patients will also notice colors are not as sharp or vibrant as they once were.
Initially, a change in your glasses may improve your vision. If this does not help, cataract surgery is the ultimate solution. Cataract surgery is a simple, relatively painless procedure to regain vision. It is one of the most common surgical procedures performed in the United States, with more than 3 million Americans undergoing cataract surgery each year. Not only is it one of the most common surgeries performed in the U.S., it is also one of the most successful operations performed with most people regaining excellent vision.
Cataract Surgery Basics
Cataract surgery is a relatively simple procedure performed on an outpatient basis, meaning you will not be staying in the hospital. In the early days of surgery, patients were put to sleep or were placed under anesthesia with a needle to the eye. This technology has improved significantly — we now use “eye drop” anesthesia in which no needles are used and the patient is awake with no discomfort during the procedure.
The surgeon uses a blade to make a very small incision in the eye. The cloudy lens is then broken up using a procedure called phacoemulsification. This device uses ultrasound energy to break up the cataract into multiple small pieces. This is similar to a pneumatic drill breaking up concrete into small pieces. The cataract remnants are then removed from the eye.
After all remnants of the cloudy lens have been removed from your eye, the cataract surgeon inserts a clear intraocular lens, positioning it securely behind the iris and pupil, in the same location your natural lens occupied.
Stitches are not commonly used in this surgery. Patients are capable of walking out from the surgery and can typically resume most of their daily activities that same day.
Laser Cataract Surgery
Just like LASIK surgery, numerous advances in laser technology have been applied to cataract surgery. One of the most recent and dramatic is the use of a femtosecond laser instead of a high frequency ultrasound device to break up the cataract. These lasers offer the advantages of doing the surgery without the use of any blades entering the eye and instead implements laser precision cuts. This method is known for reducing astigmatism and safely breaking the up the cataract without entering the eye.
Intraocular Lens Implants
After the cataract is removed from the eye, artificial lens implants (IOLs) have to be inserted. Otherwise, patients would have to wear high-powered “Coke bottle” glasses afterwards. IOLs have been around since the mid-1960s, though the first FDA approval occurred in 1981.
Standard or monofocal lens implants offer clear vision at only one distance, usually distance vision. This mean that you must wear eyeglasses or contact lenses in order to read, use a computer or view objects at arm’s length.
Premium IOLs: Multifocal & Accommodating
New lens technology makes it possible for cataract surgery to help improve both near and distance vision. These new multifocal lenses offer the possibility of seeing well at more than one distance, without glasses or contacts. These lenses offer patients the possibility of using no glasses after cataract surgery.
Presbyopia-correcting IOLs are considered “premium” lenses, which means that you must pay any associated extra cataract surgery costs yourself. Medicare and most health care plans will not cover these extra costs, because the additional benefits of these IOLs are considered a luxury and not a medical necessity.
Toric IOLs for Astigmatism
Toric IOLs designed to correct astigmatism also are considered “premium” lenses, and — like multifocal and accommodating IOLs — will likely cost extra because of the benefits that are unavailable in conventional IOLs.