Cataracts

 In Conditions & Treatments

Cataracts

I

f you are over 60 years of age, it is likely you or someone you know has cataracts.  This is because cataracts affect over 22 million Americans over 40 which is about 1 out of every 6 people in this age range.  Studies have shown that by age 80, more than half of all Americans have visually significant cataracts, and many of these already had cataract surgery.

What are cataracts?

A cataract is a clouding of the naturally clear lens of the eye. Symptoms include blurry or hazy vision and diminished night or reading vision. Often patients see glare and halos around headlights while driving at night.  Cataracts are progressive in nature and their symptoms worsen over time.

Can I prevent cataracts?

All of us will get cataracts in due time. Early in life, protecting the eyes with ultraviolet coating in glasses and sunglasses can be beneficial in delaying cataract onset.  For those with medical conditions like diabetes mellitus, optimizing blood sugar control aids in cataract prevention as well as general eye health.  However, there are currently no proven medications or diet supplements to definitively prevent cataracts.

What happens during cataract surgery?

There are two methods of cataract surgery. One is the older, traditional method of cataract surgery using a manual or “free-hand” approach. Second is a more modern procedure called Femtosecond Laser-Assisted Cataract Surgery.

The manual approach involves performing every step of surgery manually and with nothing more than free hand cutting with a blade and ultrasound. For the majority of patients, this produces good results and improved vision.

The more modern technique of laser-assisted surgery ensures precision at every step of your procedure.  The laser is used to create a  “bubble channel” that separates the tissue, and creates a precisely centered opening into the front capsule of the cataract. Next the laser simultaneously softens and prepares the cataract for ultrasonic removal instead of manually chopping up the cataract.  Additionally, the femtosecond laser makes  “arc” incisions around the edge of the cornea to reduce or eliminate corneal astigmatism, something that cutting freehand is imperfect at performing no matter how steady the surgeon’s hand.

The advantages of femtosecond laser-assisted cataract surgery are that every step of the procedure is performed with laser precision and postoperative vision is expected to be better when compared to manual cataract surgery.

Are there different types of lens implants?

There are 3 different types of lens implants.  A basic single focus implant, a multifocal implant and an astigmatism correcting implant. The single focus (“monofocal”) lens implant allows a person to see at near or at distance, but not at both ranges. This type of basic implant is typically covered by most insurance companies and Medicare.  The astigmatism-correcting lens implant is called a TORIC lens, enabling patients to see at distance after surgery. The multifocal lens implant allows the patient to see well both at near as well as at distance, giving a broader range of vision.  The TORIC and multifocal implants are premium options that are partially covered by Medicare or insurance, meaning there is an out-of-pocket investment by the patient who desires these optional vision benefits.

Summary

The methods of cataract surgery differ depending on the surgeon’s training and experience, and while some prefer to stick with the basic manual surgery, laser-assisted cataract surgery is becoming the preferred method by the more progressive cataract surgeons worldwide.   There are wonderful choices of lens implants available to the modern cataract patient.  When the time comes for cataract surgery verify that your surgeon offers a full range of lens and surgical options. It may be one of the most important decisions you’ll ever make in your healthcare.

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