What Are Cataracts?
A cataract is an opacity (cloudiness) which occurs in the lens of the eye. The lens is a natural tissue within the eye that is responsible for focusing light onto the retina. Normally, we are born with crystal clear lenses. Over time, the lens turns yellow due to the natural aging process. This yellowing of the lens helps to protect the retina by filtering harmful ultraviolet (UV) radiation from the sun. In some people, however, the lens becomes excessively cloudy and can impair vision. This can occur at any age. If we live long enough, we will all eventually develop cataracts.
The most common symptom of a cataract is blurred vision which cannot be corrected by glasses. Many people with cataracts will notice trouble driving at night due to glare from headlights and street lamps. As there are many causes of blurred vision, an eye doctor should examine your eyes to determine the cause of your symptoms.
Most cataracts occur naturally with age. They are usually not due to disease. People with certain medical conditions, such as diabetes, will tend to develop cataracts at a younger age. Cataracts have also been found to occur earlier in people who are exposed to the sun and in smokers. There are also several medications that have been shown to cause the development of cataracts to occur at an earlier age.
At The Eye Care Institute, we discuss how the cataract is affecting your vision and your lifestyle before we make a recommendation. If a cataract has impaired your vision to the point that you are not able to do things that you would like, such as driving or reading, we will often recommend no- stitch small incision cataract surgery.
In certain instances, we may recommend removing the cataract even if it does not bother you. For instance, if the cataract is too cloudy for the doctor to see the back of your eye, we may recommend that you have cataract surgery so that your eye can be properly examined. Occasionally, a cataract may cause glaucoma, a sight-threatening eye disease, and removing the cataract may be necessary in order to prevent damage to the eye from glaucoma.
You could say, “What are the benefits of having clear vision again?” Once cataracts have clouded your vision it can seem as if you’re continually looking through a dirty window. That’s no way to see the beauty of Kentucky. When Dr. Greene, Dr. Meyer, or Dr. Pattar remove the clouded natural lens and replace it with an artificial intraocular lens (IOL) your vision in that eye is instantly clear again. Plus, the new multifocal IOLs available can provide clear vision at all distances, and they can even correct for presbyopia, the near universal condition where we need reading glasses for up close vision after we turn 40.
The surgery is performed while the patient is awake, using local anesthesia. The ophthalmologist will use a local anesthetic to make the eye numb so that you will not have pain during the surgery. A small incision is made into the eye to allow access the lens. The cloudy lens will then be removed with microsurgical instruments using a state-of-the-art technique called phacoemulsification.
After the lens is removed, the surgeon will usually implant an artificial lens which will take the place of the cloudy lens that was removed. The artificial lens is called an Inter Ocular Lens.
After your surgery, you return home. There is sometimes minimal discomfort that may be relieved with over the counter pain reliever.
Dropless Cataract information
In an effort to make cataract surgery more convenient to our patients, The Eye Care Institute is proud to offer dropless cataract surgery through the administration of a medication called Trimoxi. Trimoxi is a time released cortisone and antibiotic compounded medicine that is placed inside the eye by your surgeon at the end of surgery.
Since no drops will need to be purchased, Trimoxi is less cost to the patient. As with all medications, Trimoxi has side effects. The most common side effect is the presence of floaters which may appear like a cloud. It is every patient’s choice whether to use this method of medication administration or to use traditional eye drops after surgery.
At The Eye Care Institute, Dr. Brennan Greene, Dr. John Meyer, and Dr. Guru Pattar perform cataract surgery. Dr. Greene, Dr. Meyer, and Dr. Pattar have almost 30 combined years’ experience performing cataract surgery and have performed over 35,000 cataract surgeries combined. Although not to be considered a guarantee of your result, our typical cataract surgery patient ends up with 20/20 vision post-operatively. So, our eye doctors have the experience and the proven results to give you the peace of mind to make the right choice for your cataract procedure.
Once a cataract is removed, it does not grow back. However, a clear membrane is left behind the IOL at the time of surgery. Over time, this membrane will haze, causing decreased vision and increased glare. Usually it is several years after surgery when haze becomes significant. When the haze is significant, a laser procedure can be performed (YAG capsulotomy) to clear it. This is a one-time procedure which is performed in the office.
Traditionally the IOL implanted is a monofocal lens, which means that it corrects only one range of vision. After the monofocal lens is implanted, most people will need at least reading glasses. This type of lens is typically covered by your insurance provider. Technological advances have been made that allow patients to be less dependent on glasses. There are two types of Premium IOLs, the multifocal and the astigmatism correcting.
The multifocal IOL, such as the ReSTOR, is designed to correct near, far and intermediate vision, greatly reduces the dependence on glasses. The astigmatism correcting lens, called the Toric IOL, is designed to give the patient crisp, clear distance vision without the need for glasses. Only you and your doctor can decide which lens you may be a candidate for. For more information please visit our premium IOL page.
Recovery after cataract surgery is not difficult at all. That’s a good thing for the 3.3 million Americans that have cataract surgery every year. Within 15 minutes after the procedure, most of our patients walk out of the surgery center, being surprised it was so simple. Depending on what’s right for you, your surgeon may offer you dropless cataract surgery (the surgeon instills antibiotics and steroids during the surgery, so you do not need to use post-operative drops). For others, one or two eye drops per day, for up to a month, might be best for you. For most patients, we find that eye patches and eye shields are not necessary. If you have had dropless cataract surgery, you might find your vision is blurry for a few days until the medicine in your eye is fully absorbed by your body. For most people, vision sharply improves during the first 48 hours.
Full healing can take up to two months, but you can return to almost any activity other than weight lifting or swimming, within one day.
Depending on your lens choice, you may or may not require glasses for some tasks after your surgery.
If both your eyes have cataracts, we schedule the second eye for surgery one to two weeks after the first; they are not done at the same time.
Although certain circumstances dictate that a laser may be beneficial for the first portion of the cataract surgery procedure, the use of the LenSx laser does not affect cataract surgery recovery or healing.
Cataract surgery is among the most common and successful surgical procedures performed today. Over three million Americans have cataract surgery yearly with an overall success rate over 98 percent. Those are incredible numbers when you think about it.
Complications are very rare, but they include:
- Posterior capsule opacity
- Intraocular lens dislocation
- Eye inflammation
- Light sensitivity
- Photopsia (flashes of light)
- Macular edema (swelling of the central retina)
- Ptosis (droopy eyelid)
- Ocular hypertension (elevated eye pressure)
As mentioned, these complications are very rare, but most are minor and can be successfully addressed medically or with additional surgery.
Some people put off this surgery because they are afraid of having surgery on their eyes. But the technology and skill used for these procedures at The Eye Care Institute ensures you’ll have a successful procedure. And we guarantee you’ll love your crystal-clear vision afterwards.
People assume surgery to remove a cataract-clouded lens would involve lots of pain. Not in the least. The reality is that this procedure is painless. You can choose your anesthetic choice. Most patients opt for a mild sedative to help them relax, and then we typically only use anesthetic eye drops during the procedure.
After your surgery, you may have some minor eye discomfort, but this is easily manageable with over-the-counter pain medication.
There is a good deal of variation in the cost of cataract surgery because you have many different options for your intraocular lens that will replace your cataract. The actual amount you pay for cataract surgery is contingent upon the type of intraocular lens you select. If you select a standard IOL and you are over 65, Medicare could cover the entire procedure, after any deductible or co-pays are covered. The same is true for most private insurance plans. If you opt to have more advanced IOLs, such as multifocal (they allow for excellent vision at all distances and can remove the need for reading glasses) or toric (they correct for astigmatism) options, your cost will be higher. Our team at The Eye Care Institute will estimate the possible costs of your cataract surgery during your consultation.
We typically advise our cataract patients from Louisville are the surrounding areas to not scrimp on their IOL choices. After all, this is your vision you’re talking about. You will have crystal clear vision after cataract surgery, but you can also be free of reading glasses with the new lens options. We’ll discuss your lens options with you, so that you can have a good idea of the marvelous IOL choices available today.
If you have Medicare, it covers cataract surgery. This includes the placement of a monofocal intraocular lens. Should you instead opt to have the one of the newer multi-focal lens implants, there will be some out-of-pocket cost, but patients feel it is worth it for the vision improvement at various distances. Private insurance also covers cataract surgery. Odds are, the procedure will be mostly, if not completely, covered by your insurance, whether private or Medicare.