Cataract

What is Cataract?

Cataract is the gradual darkening of the natural lens of the eye. The development of cataract starts at birth. Every day, the natural lens of the eye accumulates metabolic byproducts and turns slightly more opaque. There are many different types of cataract.  However, the most common kind of cataract, called nuclear sclerosis, usually does not cause visual problems until after the age of 50.

What is “visually significant” cataract?

At some point in many people’s life, cataract becomes what is commonly referred to as “visually significant.” Visually significant cataract causes blurred vision to the extent that it interferes with activities of daily living. People with cataract have particular issues with driving at nights and seeing in situations when there is a lot of ambient light. This is because the the cataract reflects ambient light in random directions, creating image blur. It is usually at this point that it is considered beneficial to have a cataract extraction procedure.

How is cataract surgery performed today?

Cataract surgery has advanced significantly over the last 50 years. Today, most surgeons perform cataract surgery through two small incisions into the front of the eye which measure about 1 and 3 mm. There are usually no sutures involved. The surgery is performed under topical anesthesia, which means patients are given some relaxing medication but are awake during the procedure. The procedure takes an average of about 15 minutes to complete (although sometimes shorter and at times longer).

What is the technique that is used for cataract surgery today?

The technique most commonly used today for cataract surgery is called phacoemulsification. Phacoemulsification uses ultrasonic technology to break up the cataract into small pieces and suction the small peaces of cataract out of the small incisions made in the eye. After the cataract is removed, an artificial intraocular lens of gummy consistency is placed in the capsular bag where the original cataract was situated.

What options are there in intraocular lenses?

Until recently there was only one option of monofocal intraocular lenses. The monofocal lenses replaced the cataract and helped focus light in order to project a good picture in the human eye. These lenses worked well in providing good vision without glasses for patients that did not have astigmatism on the surface of the eye. However, most patients with significant astigmatism on the surface of their eyes would need glasses to see clearly both in the near and in the distance. With recent advances in technology today, there are intraocular lenses (for example the Alcon Toric intraocular lens) that correct astigmatism on the surface of the eye. In addition there are multifocal and accommodating lenses (such as Krystalens, Restor, and Tecnis) that can provide good vision without glasses in the near, midrange, and distance. Each kind of intraocular lens has its own advantages and disadvantages. During your cataract consultation, your San Diego LaserVision ophthalmic surgeon will explain in detail all different options of intraocular lenses and help make the choice that best fits your lifestyle and expectations.