Cataract Surgery

A cataract is a progressive clouding of the eye’s natural lens. As a result, there is interference with light passing through to the retina resulting in impaired visual clarity. Symptoms may include difficulty reading or driving, glare, halos, and perhaps double vision.

While there is no medical treatment that can reverse the development of cataracts, there is a way to achieve clear vision with the surgical removal of the cataract, and the implantation of an Intraocular Lens.

There have been dramatic improvements in surgical techniques, and in the quality of Intraocular Lens in recent years. In fact, new lenses have been developed that address a range of vision problems. If your doctor advises you to have a cataract consultation, be sure to ask the surgical coordinator to describe the revolutionary Toric and Multi-focal lenses, so you can make the determination for yourself if it’s the right lens for you.

Monofocal lens and Monovision
This common IOL type has been used for several decades.

• Monofocals are set to provide best corrected vision at near, intermediate or far distances.
• Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.
• Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called "monovision." The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses.
• Presbyopia is a condition that affects everyone at some point after age 40, when the eye's lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.
   

Multifocal Lenses
These newer IOL types reduce or eliminate the need for glasses or contact lenses.

• In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.
• The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal IOLs are placed in both eyes.
• It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.

Considerations with multifocal IOLs

• For many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses.
• Each person's success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their Eye M.D. about toric IOLs and related treatments.
• Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.
   

Toric IOL for astigmatism
This is a monofocal IOL with astigmatism correction built into the lens.

• Astigmatism: This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.
• People who want to reduce (or possibly eliminate) the need for distance eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea's shape to be rounder or more symmetrical.