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Cataract Sugery and Intraoclar Lens Implantation

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Truly advanced cataract surgery using state-of-the-art cataract removal techniques and intraocular lenses.

What is a cataract? A cataract is the gradual clouding of the natural lens, which lies directly behind the pupil. Think of it as the lens inside a camera that focuses the image on the film. In the eye, the natural lens helps focus the image onto the retina, or the back of the eye, which carries the visual image from the eye to the brain. A cataract is not a film that grows over the eye. It is not caused by overuse of the eye. It does not spread from one eye to the other and it is not an irreversible cause of blindness.

The primary cause of cataract development is unknown, but it is believed to be related to chemical changes within the eye during the natural course of aging. A family history of developing early cataracts as well as systemic medical problems, such as diabetes or inflammatory condidtions, are also probable causes. Other common causes of cataracts include injury to the eye, whether blunt or penetrating, long-term unprotected exposure to sunlight and previous eye surgery.

Cataracts, as well as other conditions that may cause blurred vision, can be easily detected with a thorough eye examination in our clinic. Cataracts affect approximately 80% of individuals over the age of 60, but a diagnosis of cataracts does not mean that surgery is indicated. Statistically, only about 3% of the population will ever need surgical correction. Unfortunately, neither diet nor dietary supplements can prevent or slow the development of cataracts, although both are important to maintain good overall health of the eyes.

Cataracts do not have to get “ripe” as was believed decades ago before they can be safely removed. When a patient is developing a cataract, their common symptoms are gradual and painless blurring of the vision in one or both eyes, glare and light sensitivity when facing bright sunlight during the day and headlights at night, double vision in one eye. When a patient is developing a cataract, brighter light will be necessary in order to read fine print and colors will gradually have a yellowing tinge. This color deprivation is so gradual that the patient is not aware of it until one of the cataracts have been removed and the difference between the two eyes is noted. It is very common for a patient to comment on color brightness after surgery.

When the symptoms of visual handicap get to a point that the cataract is interfering with daily activities such as working, driving, watching TV, taking medications, etc., surgery is recommended. Techniques and instrumentation used in modern surgery are so far advanced, that the surgery takes approximately ten minutes and is performed under topical anesthesia with mild conscious sedation. The surgery is performed on an outpatient basis using the most advanced microsurgical equipment, techniques and intraocular lens implant that affords the best possible postoperative vision. In 99.9% of cases, no shots, needles or stitches are used around the eye. This is the safest and most effective form of cataract surgery by far and it enables the patient to use the eye the same day rather than waiting 24 hours to remove the patch.

The reason that Moulton Eye Clinic uses topical anesthesia for 99.9% of their cases is that we feel it is safer. There is no need for retrobulbar or peribular anesthesia, that necessitates the use of a needle with the injection. Such injection can be associated with hemorrhaging around the eye, which can be severe enough to cause total loss of sight.

In 99.9% of cases, the patient can undergo cataract surgery without discontinuing any of their regular medication, including anticoagulants or blood thinners. Patients with diabetes on oral medication will be instructed on when to discontinue the medication preoperatively, if indicated. These patients are instructed to advise their medical doctor of the surgery and medication instructions preoperatively.

The patient can use the operated eye the same day and will begin a regimen of eye drops. When the surgery is scheduled, the patient is given detailed instructions on their use and frequency as well as samples and/or prescriptions.

One of the newest advances in cataract surgery is the accommodative intraocular lens that are designed to not only give the patient clear vision at distance, but also close-up visual acuity in the vast majority of people.

At most of the facilities where we perform surgery, Moulton Eye Clinic utilizes the Alcon Infinity phaco machine for cataract surgery. These machines cost approximately $114,000 each and are by far the most effective and flexible systems in use for safe cataract surgery, reducing the risk of possible complications. We hope to have these machines at all of our facilities in the near future. This is not to say that the other machines being used are not good. On the contrary, they are extremely efficient machines and have been state-of-the-art for decades.

After surgery, the patients are instructed to contact our office if they experience even the slightest problem, such as pain or decreased vision. In this instance, we arrange to see the patient immediately.

As with any surgery, risks and complications are possible. Approximately 98% of cataract surgeries are uneventful, but when complications do occur, the majority disappear with time and proper treatment. We try to get patients as close to 20/20 as possible with the implant. However, some patients will need some form of prescription eyeglasses postoperatively, especially for reading.

At some point after cataract surgery, approximately 5% to 10% of patients will develop cloudy vision in the operated eye. Most commonly, this is caused by a clouding of the natural clear capsule bag that had previously held the cataract and now holds the implant. A laser machine is used in the office to open the capsule bag. The procedure usually takes 20-30 seconds and is painless. Immediate improvement in visual acuity is attained.

In conclusion, cataracts will develop in all of us in due time, but surgical correction has never been better. We at Moulton Eye Clinic will stay abreast of the latest advances as they become available, and make them available to our patients.