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Cataract Surgery

A cataract is the clouding of the normally clear lens of the eye. The clouding prevents light entering the eye from being focused on the retina. The lens clouds naturally as we age, resulting in a gradual decrease of eyesight. Cataracts usually progress slowly to cause visual loss and are potentially blinding if left untreated. The condition usually affects both eyes, but one is usually affected earlier than the other. In the United States of America, age-related lens changes have been reported in 42% of people between the ages of 52 to 64, 60% of people between 65 to 74, and 91% of people between the ages of 75 to 85.

The experienced surgeons of Florida Eye Clinic perform over 4,000 successful cataract surgeries every year. Since the Florida Eye Clinic Ambulatory Surgery Center opened in 1984, over 100,000 successful surgeries have been performed, making Florida Eye Clinic the surgical center with the longest experience with high-tech cataract surgery in Central Florida.

Cataract Surgery

A cataract is a clouding of the lens of the eye; cataract surgery is performed to improve vision by replacing the clouded lens with an artificial one. Cataracts affect millions of people in the United States each year. Most cataracts are the result of aging, though some form as a result of genetic factors, disease, or injury. Cataract surgery is common and considered safe and effective.

Reasons for Cataract Surgery

Cataracts can cause blurry vision, and increase the glare from lights. In their early stages, cataracts usually are not troublesome but, as they thicken, surgery to remove them may be required. Typically, surgery is needed because cataracts are interfering with everyday activities or the treatment of another eye problem.

Candidates for Cataract Surgery

Cataracts caused by aging develop gradually, and patients may not notice the early vision changes they cause. It is only when their cataracts start interfering with vision that patients may become aware of them. An ophthalmologic examination will detect cataracts, and rule out other causes for vision issues, such as glaucoma or macular degeneration. Patients who become aware of visual difficulties related to cataracts usually experience, especially at night, clouded, blurred, or dim vision.

Benefits of Cataract Surgery

Cataract surgery’s benefits are many, greatly enhancing the quality of life. They include the following:

Improved quality of vision (sharper images, brighter colors)
Less difficulty with routine tasks (particularly night driving)
Decreased dependency on eyeglasses
Greater independence, regardless of age or disability
Greater safety

Research indicates that the improved vision provided by cataract surgery reduces the risk of falls, making exercise, sports and hobbies safer. This, combined with the improved ability to read, recognize faces, and perform everyday activities with greater ease, results in improved physical health, increased sociability and longer life expectancy.

The Cataract Surgery Procedure

After the pupil is dilated, and the area in and around the eye is numbed with anesthesia, a tiny incision is made to insert an ultrasonic probe. The probe emulsifies (breaks up) the cloudy lens into tiny pieces that are then suctioned out of the eye. Once the cloudy lens has been removed, an artificial lens is implanted.

The new lens, known as an intraocular lens (IOL), is often inserted through the original incision. Some varieties of IOLs serve multiple purposes, such as blocking ultraviolet light or working as bifocals. Depending on the type of IOL used, sutures may or may not be needed.

Surgery is usually performed on an outpatient basis in a doctor’s office, takes only 20 to 30 minutes, and is relatively painless. A very high percentage of patients demonstrates improved vision after the procedure.

Recovery From Cataract Surgery

Immediately after surgery, an eye patch is worn; some doctors advise wearing a protective shield, even when sleeping, for several days. Vision may be blurry at first, but improves within a few days. Some itching and discomfort are also present for a few days, but it is important that a patient not rub or exert pressure on the treated eye. Heavy lifting should be avoided. Eye drops to prevent inflammation and infection, and control eye pressure are prescribed.

Even though full healing can take up to 2 months, because cataract surgery is performed on one eye at a time, daily activities can be resumed in a few days. Most patients need to wear eyeglasses, for at least some tasks, after surgery. If the other eye also has a cataract, which is usually the case, the second surgery is scheduled a month or two after the first.

Risks of Cataract Surgery

Although cataract surgery is a common procedure and considered quite safe, any surgery poses risks. In the case of cataract surgery, there is a slightly increased risk of retinal detachment, a painless but dangerous condition. Other risks of cataract surgery include bleeding and infection. The risk of complications after cataract surgery is greater if the patient has another eye disease or serious medical condition. Danger signs of complications after cataract surgery include increased pain in or redness of the eye, light flashes or floaters, diminished vision, nausea, vomiting or intense coughing.

IOL Taken Out of Package

Custom Cataract Surgery

Patients who are nearsighted or farsighted can usually have these visual problems corrected at the time of traditional cataract surgery using a standard or monofocal intraocular lens (IOL). These patients often have great distance vision without glasses but depend on reading glasses up close.

With custom cataract surgery however, the goal is to improve vision and decrease dependence on glasses or bifocals. The majority of patients who choose custom cataract surgery report that they can read a book or magazine, work on the computer, drive in daylight or night, play golf and tennis with increased freedom from glasses. Custom cataract surgery addresses two conditions: astigmatism and presbyopia.

Astigmatism Correcting Intraocular Lenses

When the surface of the cornea has an uneven curvature, vision becomes distorted. This irregularity is called corneal astigmatism. A person who has both a cataract and corneal astigmatism will not have clear distance vision after cataract surgery unless the astigmatism is also corrected. There are several options your surgeon can choose from to correct astigmatism, including Lasik vision correction or limbal relaxing incisions. At the time of the cataract surgery however, your surgeon can choose a special astigmatism correcting intraocular lens called a Toric intraocular lens. This is an implantable lens that makes it possible to treat the cataract and correct corneal astigmatism at the same time.

Presbyopia Correcting Intraocular Lenses

Presbyopia is an age-related condition that most people over the age of 40 experience. This condition results in the difficulty seeing up close without bifocals or reading glasses. Patients who have traditional cataract surgery with standard monofocal intraocular lenses develop “instant presbyopia”, because these intraocular lenses focus at only one distance. Most patients usually need glasses for near and intermediate distance. By choosing custom cataract with a presbyopia correcting intraocular lens however, patients are usually much less dependent on glasses or bifocals at all distances. If you are considering cataract surgery, you may be a candidate for custom cataract surgery with a presbyopic correcting intraocular lens that can provide a full range of vision. This means that one may see clearly at distance, near and in-between with little or no dependence on bifocals or reading glasses. There are several types of presbyopia correcting intraocular lenses. Your surgeon will take careful measurements of your eye and discuss with you your lifestyle needs. You and your surgeon will then decide together which lens is the best for you.

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