Intraocular lens implants shown with a dime.
What is a cataract? A cataract is a clouding of the clear lens of your eye, which may result in reduced vision. This happens naturally with aging.
Cataracts can also be caused by:
• trauma to the eye from an injury or
other ocular surgeries
• medications such as prednisone taken
for a long period of time
• heredity
• radiation
• (can be associated with) certain diseases
(i.e. diabetes, atopy, Down's syndrome,
and myotonic dystrophy)
•certain eye diseases can also result in
cataract formation
A clear lens and a lens clouded by a cataract.
How do I know my cataract is ready to be removed?
Your cataract is ready to be removed if you are no longer able to see to do the things you would like to do (for example, reading fine print, driving at night, golfing, etc.) Also, if you are not having problems with your eyes but you no longer pass your driver's test, you may need to have your cataracts removed in order to drive again.
A cataract, glare from the incoming light rays.
More rarely, cataracts are removed to treat other eye diseases.
Do cataracts hurt your eyes? In very few cases, cataracts can close the drain in the eye, causing angle closure glaucoma. This is a dangerous and acute form of glaucoma where pressure becomes very high in a short period of time. Your eye doctor will tell you if you are at risk for angle closure glaucoma. You may not have any signs or symptoms until the actual attack. In this case the cataract is putting the health of the eye at risk and should be removed. A laser procedure can be performed to alleviate this problem if your cataract is not reducing your vision enough to need surgery. If cataracts become too advanced, they can harm the eye by causing inflammation.
Is cataract surgery covered by insurance? Usually it is covered, as long as the vision is reduced enough to impair your lifestyle. Each insurance company is different and may have slightly different requirements about the level of decreased vision.
I understand there are different types of cataract surgery.
Which is the best procedure?
Extracapsular cataract surgery is the old method. A large incision is made in the eye to remove the cataract, and many stitches are used to close this large wound. These stitches can cause astigmatism in the eye. This procedure also requires more extensive follow-up and recovery.
Sutures after extracapsular cataract surgery
The newer procedures use smaller incisions that do not require stitches to close the wound. They use the process of phacoemulsification, which involves a tiny ultrasound and vacuum that breaks up the lens and sucks the "emulsified" lens fragments out of the eye through a very small incision.
Phacoemulsification
An intraocular lens (IOL) implant is inserted in the natural lens capsule that is left in the eye.
An intraocular lens implant
The result is less time spent in the operating room, and the incision heals faster, so you are back to your usual routine in days instead of weeks. It is an outpatient procedure that takes about 15 to 20 minutes. You will probably spend a few hours at the surgery center or hospital being prepared for surgery. You will go home after the procedure with a patch, which is removed at your visit the next day in our office.
Isn't cataract surgery done with a laser? Many people are sure they had their cataracts removed by a laser. Cataract surgery performed by laser is only in its infancy, and has not been proven to be safer or more effective than phacoemulsification. Therefore, it is not routinely performed.
Cataract surgery is performed through a small incision with an ultrasound, as described above. The laser is used after cataract surgery to perform a capsulotomy (see secondary cataract explanation below).
How experienced is your surgeon? Dr. Schrenk is a very competent and experienced surgeon. He has been in practice for almost 20 years. On an average, Dr. Schrenk performs approximately 50 cataract surgeries a month.
What does the follow-up after the surgery involve? The patient is sent home the day of the surgery, and seen the following day in the office for the one-day follow up visit. Drops and written instructions on how to take care of the eye will be given at this appointment. The next appointments occur one week and one month later. Most people can resume their usual activities 24 to 48 hours after surgery.
What is a secondary cataract? The lens of the eye is removed during surgery, the natural bag or capsule of the lens remains intact so that the implant can be placed within it. Months to years after your surgery this capsule can cloud over and blur your vision. This is very easily remedied with a laser procedure called a capsulotomy. In this outpatient procedure a hole is made in the cloudy capsule with a laser. This restores vision almost immediately.
If my other eye needs surgery, how soon can I have it done? Usually, six weeks after the first cataract is removed, we can safely perform the procedure on the other eye if it is in need of surgery.
What are the risks of cataract surgery? It is important to understand that with any surgery there are risks, even if the surgeon does nothing wrong and all goes well. These problems can be as serious as death, loss of the eye, and blindness. These occurences are all extremely rare.
The more common side effects of cataract surgery, usually treatable with medications include: 1) swelling within the retina (called cystoid macular edema), or 2) inflammation in the front of the eye that persists longer than 5 weeks after surgery. These side effects usually respond well to anti-inflammatory eye drops.
Will I need glasses after the surgery? Depending on what prescription you started with, you may need glasses for distance vision, near vision, or both. Many patients have excellent distance vision without glasses, and only need correction for reading.
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