Cataracts

A cataract is a loss of transparency, or clouding, of the normally clear lens of the eye. As one ages, chemical changes occur in the lens that make it less transparent. The loss of transparency may be so mild that vision is hardly affected or so severe that no shapes or movements are seen, only light and dark. When the lens gets cloudy enough to obstruct vision to any significant degree, it is called a cataract. Glasses or contact lenses cannot sharpen your vision if a cataract is present.

An eye with an intraocular lens in place following cataract surgery
 

The most common cause of cataract is aging. Other causes include trauma, medications, (such as steroids) systemic diseases, (such as diabetes) and prolonged exposure to ultraviolet light. Occasionally, babies are born with a cataract.

Reducing the amount of ultraviolet light exposure by wearing a wide-brim hat and sunglasses may reduce your risk for developing a cataract, but once developed there is no cure except to have the cataract surgically removed. Outpatient surgical procedures can remove the cataract through either a small incision (phacoemulsification) or a large incision (extracapsular extraction). With the invention and advancement of phacoemulsification, cataracts are rarely removed by extracapsular extraction. The time to have the surgical procedure is when your vision, as a result of your cataract, interferes with your lifestyle.

Cataract surgery is a very successful operation. One and a half million people have this procedure every year and 95% have a successful result. As with any surgical procedure, complications can occur during or after surgery and some are severe enough to limit vision. But in most cases, vision, as well as quality of life, improves.

Cataract Symptoms

Your eye works a lot like a camera. Light rays focus through your lens onto the retina, a layer of light sensitive cells at the back of the eye. Similar to film, the retina allows the image to be "seen" by the brain. But over time the lens can become cloudy and prevent light rays from passing clearly through the lens.


The typical symptom of cataract formation is a slow, progressive and painless decrease in vision. Other changes include: blurring of vision; glare, particularly at night; frequent eyeglass prescription change; a decrease in color intensity; a yellowing of images; and in rare cases, double vision.

Ironically as the lens gets harder, farsighted or hyperopic people experience improved distance vision and are less dependent on glasses. However, nearsighted or myopic people become more nearsighted or myopic, causing distance vision to be worse. Some types of cataracts affect distance vision more than reading vision. Others affect reading vision more than distance vision.

Phacoemulsification (Phaco)

In phacoemulsification, an ultrasonic oscillating probe is inserted into the eye. The probe breaks up the center of the lens. The fragments are suctioned from the eye at the same time. A small incision that often does not require sutures to close can be used since the cataract is removed in tiny pieces. Most of the lens capsule is left behind and a foldable intraocular lens implant, or IOL, is placed permanently inside to help focus light onto the retina. Vision returns quickly and one can resume normal activities within a short period of time.
Intraocular Lenses (IOLs)

An intraocular lens (IOL) is a tiny, lightweight, clear plastic disk placed in the eye during cataract surgery. An IOL replaces the focusing power of the eye's natural lens. The lens of the eye plays an important role in focusing images on the retina. If the lens loses its clarity, as it does when a cataract develops, light rays do not focus clearly and the image one sees is blurry. Glasses or contact lenses cannot sharpen vision if a cataract is present.

The only treatment for a cataract is to remove the lens and implant an IOL. Intraocular lenses have many advantages. Unlike contact lenses, which must be removed, cleaned, and reinserted, the IOL remains in the eye after surgery.

An IOL may be placed either in front of or behind the iris. Behind the iris is the most frequent placement site. They can be hard plastic, soft plastic, acrylic or soft silicone. Soft, foldable lenses can be inserted through a small incision which shortens recovery time following surgery.

Rapid evolution of IOL designs, materials and implant techniques have made them a safe and practical way to restore normal vision after cataract surgery. At KS EyeWorks, we are committed to offering the most advanced and technologically available IOL’s and individualizing these implants to each patients needs.

 

At KS EyeWorks, Dr. Smith is among the first surgeons in the community to utilize these revolutionary advances in cataract surgery. The following are some of the advanced intraocular lenses that he offers:

1. The Alcon Acrysof® ReSTOR® Multifocal Lens:
The most recently FDA approved intraocular lens (March 2005), 80% of Acrysof® ReSTOR® patients never needed glasses following bilateral cataract surgery, providing a full range of quality vision – near to distant.

2. The Alcon Acrysof Natural Lens: The world’s first foldable intraocular lens for cataract surgery that is specifically designed to filter both ultraviolet (UV) and high-energy wavelengths of the blue light spectrum, one of risk factors in Age-Related Macular Degeneration.

3. The Staar Toric Intraocular Lens: The only FDA approved intraocular lens to correct astigmatism. All other implants can be used to correct nearsightedness and farsightedness, but do not correct astigmatism. This implant has the ability to correct all three and is a great selection for those cataract patients that have pre-existing astigmatism.

4. The AMO Tecnis Lens: The first and only IOL that significantly reduces spherical aberration in the aging population, improving contrast sensitivity in dim light situations.

5. The Crystalens Accommodating Intraocular Lens: The only accommodative IOL available in the United States, the Crystalens provides visual correction at all distances (near, intermediate and far).