There are many known causes of cataracts including aging, diabetes, certain injuries to the eyes, certain congenital disorders, and some metabolic disorders.
The actual cataract procedure takes about 20 minutes, while the whole visit to the surgical center usually takes less than two hours. Patients arrive about an hour before the procedure and are given medications to induce relaxation and eye drops to anesthetize the eye and dilate the pupil. During the procedure, the old lens is removed and the new lens implant is inserted through a tiny incision. There is a sensation of pressure on the eye, but little or no pain. After surgery, more eye drops are applied to prevent infection and decrease inflammation. A protective patch is usually placed over the eye. Once home, the patient should rest and avoid any strenuous activities. The doctor will examine the eye the next day and advise the patient on the appropriate course of recovery, which will include continuing eye drops for a few weeks and avoiding strain on the eye until it is thoroughly healed. Be sure to arrange for someone to drive you home after the procedure.
Distance vision will usually be very good within a few days to a week after surgery. Return of near vision may take longer and depends upon which lens was selected for the procedure. Some patients still require glasses or contact lenses with a mild prescription for optimal vision. Some patients achieve better vision improvement than others, but virtually all will see better with lens replacement than without. Implant surgery is intended to correct deficiencies in the eye’s lens, and will not help with vision problems related to other parts of the eye, such as floaters, flashes, or visual field loss. This information is general and not intended to apply completely and specifically to any individual patient.
During cataract surgery, you will remain awake and receive local anesthesia in the form of eye drops and receive a sedative or other medications to help you relax. Pros of cataract surgery anesthesia include the ability to numb potential pain and keep you comfortable during the procedure. Usually, the less medication the better. Your doctor will work with you to decide on the proper dosage and level of anesthesia that will be right for. To prepare for cataract surgery and anesthesia, you will need to follow your doctor’s instructions. Refrain from eating or drinking after midnight the night before, take any necessary medications as directed, and be sure you have someone to drive you home from the procedure.
Cataract surgery is relatively quick and noninvasive. Anesthesia can make it even more seamless, although there are some potential risks for both surgery and anesthesia.
The standard cataract surgical procedure is performed on more than 3 million eyes each year, and has proven extremely safe. However, there is always a chance of complication with even the most routine surgery. Most complications, such as minor infections, inflammation, and irritation, are temporary and easily treated. Serious sight-threatening complications, such as infection, hemorrhaging, or retinal detachment, are extremely rare. About 98 percent of cataract surgery patients experience no complications and more than 95 percent achieve improved vision. As with all surgical procedures, the eye doctor will perform a thorough examination and provide a complete evaluation of expected results and possible complications.
Most patients require only a few days to resume normal activities, with some limitations and adjustments. Some sensitivity to touch and bright lights should not deter most patients from driving and returning to work. Patients are given medications to prevent infection and control inflammation. A protective shield is advisable while sleeping; sunglasses can provide protection during the day. For several days after surgery, patients should avoid any lifting or straining, which can increase pressure in the eye. Rubbing or pushing of the eye, and any situation that could result in being hit in the eye, are also to be avoided. Careful showering and shampooing are permitted, as long as no soap or shampoo touches the eye. Any makeup around the eye should be avoided for several weeks. Public swimming pools, hot tubs, and other potential sources of infection/contamination should also be avoided. When in doubt, the patient should consult their doctor for guidelines regarding post-surgical activities.
Discomfort from cataract surgery is typically minor and may only last a few days. This can make it tempting to go right back to your previous level of activity. It is important to wait at least 10 days before doing any strenuous activity, such as heavy lifting or exercise.
Try not to lift anything heavier than 5 to 10 pounds, and keep your head above your body. Avoid swimming or hot tubs for at least 3 weeks. It is important to follow all instructions and recommendations your doctor gives you for a normal recovery.
In cataract surgery, natural lenses are removed and replaced with artificial lenses, which are not subject to deterioration and should last a lifetime. Many patients experience subsequent clouding of the membrane that holds the lens, called the capsule. The normal treatment for this is a yag laser capsulotomy, in which a laser beam is used to create a hole through the membrane, allowing a clear path for light. It is a quick and painless procedure.
Your doctor will check your eyes the day after surgery and, depending on your particular case, about one week later, at four weeks, and again, about three to six months later. After that, annual eye exams are recommended, unless a specific problem develops.
The surgeon or a member of his or her team should perform the checkup on the day after surgery. The surgeon may approve subsequent checkups with another doctor after consultation with that doctor to ensure familiarity with your case and appropriate care.
Red, irritated eyes and eyestrain are often caused by inappropriately wearing contact lenses and/or dry eye syndrome. Implantation of an intraocular lens (IOL) may help the situation if it reduces or eliminates the need for contact lenses. These symptoms can be caused by several other factors, including allergies; consulting a doctor is recommended.
Security scanners usually read patterns on the iris or retina, and should not be affected by the presence of an IOL.
The advanced technology IOL is a new, state-of-the-art type of intraocular lens that can provide a fuller range of vision, from near to distance, in most patients. The procedure for removing the natural lens and implanting the advanced technology IOL is the same one that’s been used for years in cataract surgery, but the result is a full range of vision, significantly reducing or eliminating the need for glasses or contact lenses.
Unlike an ordinary IOL, the advanced technology IOL can focus on objects near and far. The PanOptix® and Vivity™ lenses have a special surface design that brings near and distant objects into focus. All the lenses are intended to provide patients with a fuller range of vision, reducing the need for corrective lenses. With standard IOLs, most people must rely on glasses or contact lenses for middle and near vision.
Advanced technology IOLs were created to provide a fuller range of vision, near to distance. Nearly everyone will find their uncorrected vision significantly better after surgery, but some will not see 20/20 through the full range of vision. Preexisting ocular and physiological factors may prevent full range 20/20 vision. Your doctor will advise you of any conditions that may affect the outcome of your individual surgery. In FDA clinical studies of PanOptix®, 80 percent of participants with the PanOptix® lens in both eyes did not use glasses or contact lenses after the procedure; 84 percent achieved 20/25 or better distance vision, 20/30 or better near vision, and could read small stock quotes in a newspaper.
Advanced technology IOLs will greatly enhance middle vision (roughly arm’s length) used for tasks such as using a computer, viewing dashboard instruments, and reading supermarket price stickers. For many patients, there is no comparison to the hassle of trifocal eyeglasses. No matter the distance—near, middle, or far—your advanced technology IOLs can put your view in focus without the annoyance of tilting your head to see more clearly.
Since the lens implant procedure replaces the cloudy natural lens with a crystal-clear IOL, the transmission of light to the retina should be enhanced. However, low-light vision is influenced by other factors, including the health of the eye in general, and of the retina in particular. With time, it is normal for low-light vision to decrease. Adequate lighting is always beneficial, especially when reading. Patients do note that there are more halos and glare with the multifocal IOL’s than compared to standard IOL’s.
Only an experienced eye doctor can evaluate your vision care needs and recommend a customized course of treatment. Most people in good general health are good candidates for advanced technology IOLs. Some patients may require an enhancement procedure by laser vision correction or other technology to achieve the best result. Those with uncontrolled diabetes, chronic infections, and certain other health problems should not have lens replacement surgery until these conditions are under control.
For the best result, advanced technology IOLs should be implanted in both eyes. Cataracts normally develop in both eyes at the same time. In the instance of only one clouded lens, only that lens needs to be replaced. For the typical patient, most surgeons prefer not to operate on both eyes at the same time. The normal procedure is to replace the lens that is most clouded first. The interval between surgeries depends on the healing of the first eye and the vision results; two to four weeks is typical.
Glare, night driving problems, and light sensitivity can occur with both traditional and advanced technology lens implants. Night vision problems are usually much less severe than before cataract surgery. These phenomena are usually temporary and diminish as the brain and eyes adjust. Light sensitivity is usually temporary. The crystal-clear material of the advanced technology IOL nearly always permits more light to pass through than the natural lens it replaces, thus patients might have to adjust to seeing vivid colors and brighter lights than before surgery. All intraocular lenses can produce glare, light flares, or a halo effect at night since the pupil is open wider and allows light to reflect off the edge of the implant. Patients do note that there are more halos and glare with the multifocal IOL’s than compared to standard IOL’s. Your doctor can usually compensate for these problems through medication or night driving glasses.
Yes. For most people, there is a period of weeks when your brain is learning to “see” up-close and at a distance with the new lens. This adjustment period is usually complete within 3 to 4 months. Also, like all multifocal lenses, some people report halos or glare around lights. Again, for most people this diminishes over time. For some, it becomes less troublesome but never completely goes away. Most people report that the ability to see near and far outweighs any visual side effects associated with the lens.
The presence of an intraocular lens does not make the eye more susceptible to damage from trauma after appropriate healing. Most injuries affect the cornea—the clear front portion of the eye—or the retina—the light-sensing lining on the rear of the eye. If anything, the lens implant eliminates the chance of cataracts due to eye trauma.
The IOL takes the place of a natural lens in the eye. Once healing is complete, usually about three months after surgery, other eye surgery will be unaffected by the presence of an IOL; it will be no different from surgery with a natural lens present. Surgery on or around the eye should also be avoided until the implant procedure is well healed; this includes BOTOX®, plastic surgery, or procedures performed on the surface of the eye. A doctor performing any procedure near the eye should be notified of a patient’s eye surgery history.
Most private insurance covers the cataract surgical procedure and the anesthesia, but rarely cover the additional cost of an advanced technology IOL, since it is considered elective. Patients should consult with both the doctor and the insurance carrier to determine their best alternatives.
Most advanced technology IOL surgeons have been thoroughly trained and have experience in performing standard cataract surgery, applying the same techniques used to implant the advanced technology IOL. A face-to-face consultation with surgeons is best to facilitate meaningful dialogue. Asking questions and building a good rapport with your surgeon is always beneficial and more comforting. Direct contact with patients who have had advanced technology IOL implant surgery is also very informative.