A cataract is a clouding of the lens of the eye; cataract surgery is performed to improve vision by replacing the clouded lens with an artificial one. Cataracts affect millions of people in the United States each year. Most cataracts are the result of aging, though some form as a result of genetic factors, disease or injury. Cataract surgery is common, and considered safe and effective.
Reasons For Cataract Surgery
Cataracts can cause blurry vision, and increase the glare from lights. In their early stages, cataracts usually are not troublesome but, as they thicken, surgery to remove them may be required. Typically, surgery is needed because cataracts are interfering with everyday activities, or the treatment of another eye problem.
Candidates For Cataract Surgery
Cataracts caused by aging develop gradually, and patients may not notice the early vision changes they cause. It is only when their cataracts start interfering with vision that patients may become aware of them. An ophthalmologic examination will detect cataracts, and rule out other causes for vision issues, such as glaucoma or macular degeneration. Patients who become aware of visual difficulties related to cataracts usually experience, especially at night, clouded, blurred or dim vision.
Benefits Of Cataract Surgery
Cataract surgery’s benefits are many, greatly enhancing the quality of life. They include the following:
- Improved quality of vision (sharper images, brighter colors)
- Less difficulty with routine tasks (particularly night driving)
- Decreased dependency on eyeglasses
- Greater independence, regardless of age or disability
- Greater safety
Research indicates that the improved vision provided by cataract surgery reduces the risk of falls, making exercise, sports and hobbies safer. This, combined with the improved ability to read, recognize faces, and perform everyday activities with greater ease, results in improved physical health, increased sociability and longer life expectancy.
The Cataract Surgery Procedure
After the pupil is dilated, and the area in and around the eye is numbed with anesthesia, a tiny incision is made to insert an ultrasonic probe. The probe emulsifies (breaks up) the cloudy lens into tiny pieces that are then suctioned out of the eye. Once the cloudy lens has been removed, an artificial lens is implanted.
The new lens, known as an intraocular lens (IOL), is often inserted through the original incision. Some varieties of IOLs serve multiple purposes, such as blocking ultraviolet light or working as bifocals. Depending on the type of IOL used, sutures may or may not be needed.
Surgery is usually performed on an outpatient basis in a doctor’s office, takes only 20 to 30 minutes, and is relatively painless. A very high percentage of patients demonstrates improved vision after the procedure.
Risks Of Cataract Surgery
Although cataract surgery is a common procedure and considered quite safe, any surgery poses risks. In the case of cataract surgery, there is a slightly increased risk of retinal detachment, a painless but dangerous condition. Other risks of cataract surgery include bleeding and infection. The risk of complications after cataract surgery is greater if the patient has another eye disease or serious medical condition. Danger signs of complications after cataract surgery include increased pain in or redness of the eye, light flashes or floaters, diminished vision, nausea, vomiting or intense coughing.
Recovery From Cataract Surgery
Immediately after surgery, an eye patch is worn; some doctors advise wearing a protective shield, even when sleeping, for several days. Vision may be blurry at first, but improves within a few days. Some itching and discomfort are also present for a few days, but it is important that a patient not rub or exert pressure on the treated eye. Heavy lifting should be avoided. Eye drops to prevent inflammation and infection, and control eye pressure are prescribed.
Even though full healing can take up to 2 months, because cataract surgery is performed on one eye at a time, daily activities can be resumed in a few days. Most patients need to wear eyeglasses, for at least some tasks, after surgery. If the other eye also has a cataract, which is usually the case, the second surgery is scheduled a month or two after the first.
ReSTOR Multifocal IOL
AcrySof® IQ ReSTOR® IOL is an intraocular lens that provides a full range of vision for patients after cataract surgery, significantly decreasing their dependence on glasses or contact lenses. The ReSTOR IOL replaces the natural lens of the eye which has been removed during surgery. Its optic design enables it to bend light to a focal point of the retina, facilitating distance vision. By distributing light on the retina in such a way that images at various distances are clearly perceived, it provides multifocal visual clarity.
The ReStor IOL has been shaped using a special process called apodized diffraction to provide increased depth of focus. Diffraction involves the bending or spreading of light to multiple focal points as it passes through the lens. Apodization is a process through which such light is gradually tapered to create a smooth transition which allows accurate focus at various distances.
The lens of the ReSTOR IOL is convex on both sides, or biconvex, and is made of soft plastic so that it can be folded prior to insertion. This allows the surgeon to make an incision smaller than the diameter of the lens itself. After the IOL has been surgically inserted into the eye, it gently unfolds to restore vision. The IOL is constructed with supporting arms which provide for proper positioning in the eye.
Candidates For ReSTOR IOL Treatment
Any individual who desires multifocal vision without the use of reading glasses, bifocals or contact lenses may be a candidate for ReSTOR IOL. While the ReSTOR IOL was originally designed for patients with cataracts, having cataracts is not necessary to qualify for the ReSTOR IOL. Patients with chronic infections, uncontrolled diabetes or other health problems may have to wait until these conditions are under control before they can undergo this corrective eye surgery.
Benefits Of ReSTOR IOL Treatment
There are several benefits to ReSTOR IOL treatment which include:
- A soft, foldable acrylic lens
- Smaller incision in the eye
- Correction for both cataracts and presbyopia
- Filtering of blue light for more vivid color perception
- Correction of spherical aberrations that appear with age
The ReSTOR IOL Procedure
The ReSTOR IOL procedure is a relatively simple one. The cataract-impaired lens of the eye is removed through a tiny incision on the edge of the cornea and replaced with the ReSTOR IOL. The procedure takes between 15 to 45 minutes to complete and is performed as an outpatient surgery. After approximately an hour of medical observation, the patient is able to leave the surgery center almost immediately. The patient usually returns for a follow-up appointment with the physician the day after the procedure. The recovery period from the ReSTOR procedure is quite short. Patients are generally able to return to normal activities the following day.
There may be some itching, discomfort and sensitivity to light after surgery. These symptoms are usually managed satisfactorily with eye drops that have been prescribed by the ophthalmologist. These symptoms almost always subside within a few days as the eye heals and patients may begin to enjoy the clarity of vision the new lenses provide.
Risks Of The ReSTOR IOL Procedure
As with any surgery, ReSTOR IOL surgery has potential complications. The chief risk associated with ReSTOR IOL treatment, and with all multifocal lens procedures, is that certain individuals simply do not adapt to the new way of seeing. Although most patients adjust in less than a month, many take as long as 6 months to a year to make the adjustment. A small number of patients are never able to adapt to the multifocal lenses which, although rare, is a serious complication.
Most of the risks associated with the ReSTOR IOL treatment are side effects common to all cataract procedures and all are complications at the surgical site. These risks may include:
- Swelling or bleeding
- Retinal detachment
- Secondary cataract formation
- Eye redness or irritation
- Sensitivity to light
- Blurred vision, halos or glare in low light
In general, ReSTOR treatment has a high rate of success with few complications. A majority of patients report improved vision right after surgery.
Intraocular lenses are used during cataract surgery to replace the damaged lens of the eye with an implant that clears up and corrects vision, oftentimes leaving patients with little to no dependence on glasses.
Up until now, patients with astigmatism did not have the same opportunities that other cataract patients have had in correcting their condition with the types of IOL lenses that were available. Typically, the astigmatic patient would need an additional surgical procedure, such as refractive surgery or LASIK, to correct their vision after the procedure. If the patient did not want to undergo another surgical procedure, the only option for correction would be the use of either contact lenses or glasses to address their astigmatism.
Toric IOLs are able to accommodate for the condition of astigmatism. Toric IOLs are specially designed to correct astigmatism along with overall vision during cataract surgery, offering complete vision correction.
The advanced Toric IOLs correct the imbalance caused by an irregular cornea shape in patients with astigmatism. There are several different types of FDA approved Toric IOLs which can correct up to 3 diopters of astigmatism.
The Toric IOL Procedure
The cataract-impaired lens of the eye is gently removed through a tiny incision that is made on the edge of the cornea. The lens is then removed and replaced with the Toric IOL. The procedure takes from 15 to 45 minutes to complete.
Following the procedure, patients will be able to return home after about an hour of observation. A follow-up appointment is usually scheduled for the day after the surgery to monitor the patient’s recovery. Recovery from the surgery is usually short, and most patients are able to return to their normal activities almost immediately.
There may be some itching, discomfort and sensitivity to light after surgery, which can be managed through eye drops that have been prescribed by your doctor. These symptoms usually go away within a few days as the eye heals and patients can begin to enjoy the many benefits of their new lens.
Risks And Complications Of A Toric IOL
As with any surgery, Toric lens surgery has potential complications. The most common side effects of all cataract procedures include:
- A sensitivity to light
These risks, however, are rare and are often outweighed by the potential benefits of restoring vision.
Complications specific to Toric IOL may include:
- The lens rotating out of position
- Loss of sharpness of vision
Toric IOLs are considered safe for most patients with astigmatism and are the only solution to correct vision problems associated with both cataracts and astigmatism.
The Zeiss IOL Master® is a high-precision measurement tool that is used to measure the axis length, corneal curvature and the anterior chamber depth of the eye. The measurements obtained provide physicians with the information needed in the selection of the right IOL to be used for the patient undergoing cataract surgery.
Approved by the FDA in 2000, the Zeiss IOL Master has proven to be five times more accurate than traditional IOL-fitting technologies. The IOL Master takes less time than an ultrasound, the traditional form of measurment which requires the use of anesthesia. The IOL Master does not come in contact with the patient’s eye so there is no need for anesthetic eye drops.