Cataracts

Cataract Surgery

A cataract is a clouding of the eye’s natural lens inside the eye which leads to a decrease in vision.  Cataracts develop slowly and don’t disturb your eyesight early on. Over time, however, as they get worse, they will interfere with your vision and you will need cataract surgery.

What causes cataracts?

Generally, cataracts form as part of the natural aging process where over time there are changes to the tissue that makes up your eye’s lens. 

Other causes may be due to

  • An injury to the eye or inflammation
  • Other eye conditions
  • Past eye surgery
  • Medical conditions such as diabetes
  • Long-term use of steroids
  • Obesity
  • High blood pressure
  • Excessive exposure to sunlight
  • Smoking
  • Drinking excessive amounts of alcohol

Even some genetic disorders that cause other health problems can increase your risk of cataracts.

What are the signs and symptoms of a cataract?

You may have a cataract if 

  • You have clouded, blurred or dim vision
  • You have increased difficulty with vision at night
  • You have a sensitivity to light and glare
  • You need a brighter light for reading and other activities
  • You see halos around lights
  • You have frequent changes in eyeglasses or contact lens prescription
  • You have double vision in a single eye

Other signs may be the fading or yellowing of colors and the realization that you aren’t able to drive anymore due to vision problems.

How does a cataract form?

As you age, the lenses in your eyes become less flexible, less transparent and thicker. Age-related and other medical conditions cause tissues within the lens to break down and clump together, clouding small areas within the lens. 

As the cataract continues to develop, the clouding becomes denser and involves a bigger part of the lens. A cataract scatters and blocks the light as it passes through the lens, preventing a sharply defined image from reaching your retina. As a result, your vision becomes blurred.

Cataracts generally develop in both eyes, but not evenly, causing a difference in vision between eyes.

Are there different types of cataracts?

There are several different types of cataracts including:

Nuclear Cataracts. These affect the center of the lenses and as cataracts progress the lenses gradually turn more densely yellow and further clouds your vision.

Cortical Cataracts. These cataracts begin as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As cataracts progress, the streaks extend to the center and interfere with light passing through the center of the lenses.

Posterior Subcapsular Cataracts. These cataracts affect the back of the lens. They start off as small opaque areas that usually form near the back of the lens, right in the path of light. As cataracts progress, they interfere with your reading vision, reduces your vision in bright light, and cause glare or halos around lights at night. These types of cataracts progress faster than other types do.

Congenital Cataracts. These are cataracts that you are born with or they develop during childhood. They may be genetic or associated with intrauterine infection, trauma, or due to certain conditions (e.g., galactosemia, rubella, etc.). They don’t often affect vision, but if they do they are removed as soon as detected.

How are cataracts diagnosed?

During your consultation, your doctor will ask you about your medical history and review your medications with you. Your eye doctor will also perform an eye examination and conduct several tests, including:

Visual Acuity Test.  An eye chart is used to measure how well you read a series of letters to determine if you have 20/20 vision or if your vision shows signs of impairment.

Slit-Lamp Examination. A slit-lamp allows your eye doctor to see the structures at the front of your eye under magnification. With the slit-lamp microscope, the intense line of light, a slit, allows your eye doctor to illuminate and examine your cornea, iris, lens and the space between your iris and cornea in small sections. This helps your eye doctor to detect any tiny abnormalities within these structures.

Retinal Exam. Your eye doctor puts drops in your eyes to open your pupils wide (dilate) to make it easier to examine the back of your eyes (retina). Your doctor can use a slit lamp or ophthalmoscope to examine your lens for signs of a cataract.

What is the treatment for cataracts?

Cataract surgery is a simple, relatively painless procedure to regain vision. It is the most frequently performed surgery in the United States, with more than 3 million Americans undergoing surgery each year.

Cataract surgery is the removal of the eye’s cloudy lens and replacing it with an intraocular lens (IOL) implant to restore the eye’s focusing power.

IOLs are artificial lenses and they have been around since the mid-1960s, though the first FDA approval for one did not occur until 1981. Before that, if you had cataracts removed, you had to wear very thick eyeglasses or special contact lenses in order to see afterward, since the natural lens had been removed wasn’t replaced with an artificial one.

At Fisher-Swale-Nicholson Eye Center, we use three different types of IOLs:

  • Aspheric Basic IOL
  • Toric Astigmatism IOL
  • ReSTOR Multifocal IOL

The Aspheric Basic IOL is also known as a monofocal lens because it has a single focal point. This is satisfactory for cataract patients who don’t mind wearing glasses or contacts following their procedure for everyday activities.

The basic IOL does not correct pre-existing conditions such as astigmatism or presbyopia (the need for reading glasses). About 1 in 3 people have astigmatism which is the curvature of the cornea that causes blurriness and distorted vision.

The Toric Astigmatism IOL can correct both cataracts and astigmatism. It is ideal for cataract patients who wish to reduce the need for glasses or contacts for distance vision following surgery.

The ReSTOR Multifocal IOL is the #1 Presbyopic Correcting Lens. It is also the most advanced technology on the market today. It corrects near, intermediate, as well as distance vision resulting in freedom of glasses and/or contacts almost all of the time!

Who would not be an ideal candidate for cataract surgery with vision-correcting IOLs?

For some patients, other eye problems prohibit the use of vision-correcting intraocular lenses (artificial lenses). In these instances, the cataract is removed, and vision is corrected with eyeglasses or contact lenses.

What options does FSN Eye Center offer for cataract surgery?

At Fisher-Swale-Nicholson Eye Center, we offer a range of options to suit your vision goals.

LENSAR Laser-Assisted Cataract Surgery

At Fisher-Swale-Nicholson Eye Center, we offer the most advanced technology available in cataract surgery–laser-assisted cataract surgery with LENSAR laser. It is a revolutionary technique to remove a cataract more accurately and make intelligent blade-free incisions.

What are the benefits of LENSAR laser-assisted cataract surgery?

LENSAR’s superior Augmented Reality takes a more intelligent approach to cataract surgery. With Augmented Reality, your surgeon can see everything inside your eye in greater detail. This allows the surgeon to plan the surgery better, to soften the cataract precisely in preparation for removal, and to ensure the appropriate condition for the most accurate placement of your intraocular lens. 

It is LENSAR’s precision, imaging and laser incisions that allow your surgeon to ensure that the cataract is safely removed and that the new intraocular lens is perfectly placed, resulting in better visual outcomes.

How does LENSAR work?

LENSAR is different because of the way it helps your surgeon view your eye, acting as a guide for your procedure. The LENSAR Cataract Laser with Augmented Reality creates a high-resolution 3-D model of your eye, allowing your surgeon to custom-tailor treatment, which can improve visual outcomes.

LENSAR is safe, effective and uses the same laser technology that has been used in LASIK procedures for over a decade. And it’s designed with comfort in mind, so you can relax, knowing you have the latest technology available to treat one of your most valuable senses–your sight!

Is LENSAR safe?

Yes, the LENSAR Laser System is safe for your eyes. The advanced technology used by LENSAR is backed by more than a decade of use by surgeons. While using a laser is new to cataract removal, the LENSAR Laser System utilizes the same laser technology used in LASIK and other well-documented procedures.

The LENSAR Laser System gives your surgeon more control and is less invasive than traditional surgery. You can have confidence and peace of mind knowing that your surgeon is guided by the precision and accuracy of the LENSAR Laser System.

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Dropless Cataract Surgery

With dropless cataract surgery, a single-use antibiotic and steroid injection are administered at the end of cataract surgery while the patient is still under anesthesia. During the following month, the eye absorbs this combination, so patients don’t have to worry about administering eye drops postoperatively.

Dr. Swale, at Fisher-Swale-Nicholson Eye Center, is one of the few eye doctors in Illinois who uses this technique.

Benefits for Dropless Cataract Surgery

Here are just some of the few demonstrated benefits for dropless cataract surgery:

More Convenient

Dropless cataract surgery reduces or eliminates the need for eye drops after cataract surgery. This translates to not having to put drops in your eyes four times a day and freeing up more time.

This is extremely helpful for cataract patients who tend to be older and more prone to physical and cognitive challenges that may make opening bottles, instilling drops and remembering dosing regimens a struggle.

Less Expensive

Patients do not have to pay out of pocket for dropless like they would for prescription drops. The dropless injection portion of the surgery is included in our surgery center fees. This translates into a potential savings of $400 for both eyes on prescription eye drops.

The traditional post-op regimen of topical antibiotic, steroid and NSAID can pose a significant cost burden to patients, even those with health insurance. Having dropless cataract surgery eliminates the need for patients to purchase both a topical steroid and antibiotic.

Safe and Effective

With dropless cataract surgery, there is a low risk of infection, retinal swelling, and other complications. Over the past few years, a number of studies have also demonstrated how placing antibiotics and steroid medications inside the eye at the end of cataract surgery is more effective at preventing these vision-threatening complications and eliminating patient compliance issues with drops. In a sentence, dropless simplifies the post-operative process for patients, making it less of a hassle to get back to seeing well and enjoying life.

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When should you consider cataract surgery?

Cataract surgery should be performed when your cataracts have progressed enough to impair your vision significantly and affects your daily life.

If you are a diabetic, you should have cataract surgery sooner than later, as cataracts can worsen faster in people with diabetes.

What can you expect from cataract surgery?

Cataract surgery is performed on an outpatient basis and takes about 20 minutes or less to perform. 

After surgery, you may see bright and multi-colored lights, as well as blurry shapes, moving in front of the eye.

The incisions made during surgery are so small (2 millimeters) that they typically do not require a suture to close them.

What if you need cataracts removed from both eyes?

If you need cataract surgery in both eyes, your eye doctor will schedule surgery to remove the cataract in the second eye after you’ve healed from the first surgery.

What is the recovery period for cataract surgery?

Healing from cataract surgery usually takes up to 8 weeks.

Are there any complications associated with cataract surgery?

All operations and procedures are risky and can result in unsuccessful results, complications, injuries, or loss of vision from both known and unknown causes.

The major risks of cataract surgery include but are not limited to 

  • Bleeding
  • Infection
  • Injury to parts of the eye and nearby structures from anesthesia
  • The operation itself
  • Or pieces of the lens that cannot be removed
  • High eye pressure
  • A detached retina
  • Droopy eyelid

Can cataracts be prevented?

There aren’t any studies that have proved how to prevent or slow the progression of cataracts; however, good overall health management can help detect cataracts and other eye problems at their earliest stages and/or diminish your risks of developing them.

Here are some tips to follow:

  • Have regular eye examinations.
  • Quit smoking.
  • Manage other health problems, like diabetes, and follow your treatment plan.
  • Choose a healthy diet that includes plenty of fruits and vegetables.
  • Wear sunglasses that block ultraviolet B (UVB) rays.
  • Reduce alcohol use.

Will cataract surgery improve your night vision?

For many patients, cataract surgery improves your night vision for driving, walking, and other activities in low light, as replacing the cataract with a crystal clear IOL typically results in a dramatic improvement in the clarity and quality of your vision. For other patients, they may still have some minor refractive errors after cataract surgery, but they can wear prescription eyeglasses to sharpen their night vision even further.

Cataract Surgery at Fisher-Swale-Nicholson Eye Center

For more information on cataract surgery, including LENSAR Laser-Assisted Cataract Surgery and Dropless Cataract Surgery options, request an appointment online for a cataract evaluation or call us at (815) 932-2020.