Evolution of Cataract Surgery

July 20, 2017

Vision loss among the aging population is a major health care problem.  Approximately one-third of the population have some form of vision-reducing eye disease by the age of 65.  The most common causes of vision loss among the aging are macular degeneration, glaucoma, cataracts and diabetic retinopathy. Approximately half of adults between 65 and 75 develop cataracts and this number is increasing every year!

According to the American Academy of Ophthalmology, a cataract is a clouding of the normally clear lens of the eye, causing vision loss that cannot be corrected with glasses, contact lenses or corneal refractive surgery like LASIK.  Cataracts are diagnosed with a thorough dilated eye evaluation by an eye doctor.  There are many types of age related cataracts and the speed at which a cataract progresses varies based on the type. 

Cataract symptoms include cloudy, blurry or dim vision, difficulty in dimly lit conditions, sensitivity to light or glare, double vision in one eye, faded or yellowed colors and frequent changes in glasses or contact lenses.

How do you know if you are at risk for having cataracts?  If you have a family history of cataracts, or have a medical condition such as diabetes, injury or trauma to the eyes, previous eye surgery or radiation, or long term use of steroid therapy.

Cataract surgery is the only treatment for cataracts. 1.8 million people have this surgery each year, making it the most common procedure performed in the United States.  The surgery is an operation to remove your eye’s lens when is becomes cloudy.  95% of the surgeries are performed without complications and result in improved vision, and 94% of patients achieved uncorrected distance visual acuity of 20/40 or better. 

The procedure is done on an outpatient basis, takes approximately 15-30 minutes and patients go home the same day.  During the surgery, your cloudy natural lens is removed and replaced with a clear artificial lens, called an intraocular lens (IOL).  Patients are awake during the procedure but it is painless as the eye is numbed with drops and gel.  After the patient goes home, topical eye drops are prescribed to prevent infection, swelling and other retinal issues.  Only one eye may be operated on at a time, and the other eye may be operated on a few weeks after if necessary.  Restrictions after surgery include eliminating pressure around the eye with bending and lifting as you heal. 

There are 3 different types of lenses that can be inserted during cataract surgery – monofocal, multifocal, or toric. Patients have more options of precision and are seeing more without glasses after surgery!

The Monofocal Lens has a single focal point, designed to correct cataracts and provide distance vision while offering enhanced image quality.  It corrects for only one distance, near or far. It will not correct astigmatism.  It is usually covered by private insurances and Medicare.

The Multifocal Lens, approved by the FDA in 2005, is a lens with multiple focus points, designed to replace cataracts and correct presbyopia in order to provide a full range of vision - near, far and in-between -  while offering enhanced quality.  There are now multifocal lenses that also correct for astigmatism. 

The Astigmatism Correcting Monofocal Lens (toric), approved by the FDA in 2011, is a lens with a single focal point, designed to correct both cataracts and pre-existing astigmatism, providing distance vision while offering enhanced image quality.  Quality of vision can be deteriorated considerably by astigmatism. 

If you can no longer see well enough to perform you job, drive safely, read and watch television, cook, shop, take medication and do yard work, it is time for you to speak to your physician about the best options available.