Cataract and Refractive Surgery

You have been diagnosed with cataracts, now what?

Approximately 21 million American adults have cataracts – a progressive clouding of the lens that can lead to loss of vision. Our cataract surgeon has helped patients with cataracts to regain their vision. First, consider your lifestyle and the new treatment options that are now available. After your cataract surgery would you rather need glasses for close, far, or computer vision? Or would you prefer to reduce or eliminate your need for glasses after cataract surgery? A bright new world is opening up for those gradually losing eyesight to cataracts. Today, advanced technology can provide a more independent and youthful option, so that, for most people, the need to wear reading glasses no longer has to be an inevitable part of aging or cataract treatment. New technology lenses add the potential to rejuvenate vision and add a more youthful, independent quality of life people have desired for many years.

What is a cataract?

A cataract is not a growth, but a normally clear lens inside the eye that has turned cloudy. Cataract surgery should be performed when cataracts interfere with a person’s ability to see for daily activities such as reading or driving. Cataracts interfere with vision by scattering light as it passes through the eye to the retina. This light dispersal causes blurred images, loss of contrast, glare, or star-burst.

What causes cataracts?

Cataracts are usually a normal part of the aging process. Cataracts typically develop by the time a person reaches his or her 60s or 70s, although they can occur at younger ages or may exist at birth. Other cataract causes can include eye trauma, inflammation in the eye, or diabetes. Cataracts usually develop in both eyes, but they may develop at different rates. Fortunately, cataract surgery is now a relatively standard procedure.

When is cataract surgery needed?

Surgery to remove cataracts is indicated when blurred vision interferes with enjoyment of activities that are important to you. Cataract surgery may be needed if you have trouble reading, enjoying hobbies, reading street signs, or driving because of blurred vision or glare from headlights.

How are cataracts diagnosed?

Cataracts are diagnosed during a comprehensive eye examination. Many factors are considered when making the decision to perform cataract surgery. These factors include: Medical History – It is important for the eye doctor to determine your eye symptoms and how they encumber your everyday life. Questions are asked about your general medical history, including any medications you are currently taking and whether you have any allergies, prior eye disease, and previous surgeries.

Eye Tests – Eye charts are used during an eye examination to determine your vision (or visual acuity). Refraction is done to determine your prescription and to see if changing glasses will improve your vision. A brightness acuity test (BAT) may be used to see how much glare you are experiencing.

Eye Inspection – Your eye doctor uses a slit lamp to examine the front structures of the eye, including the clarity of the cornea and lens. Special lenses are used to examine the back structures of the eye, including retina and optic nerve. Eye pressure is checked with a tonometer. The doctor determines if it is a cataract that is obscuring vision and not another disease. This will help the doctor decide if your vision is likely to be improved by removing the cataract.

If cataracts are present, then you and your doctor can discuss your treatment options. If you are still functioning well and activities are not limited by the quality of your vision, a decision may be made to wait before removing the cataract. If helpful, a change of glasses may be recommended. The decision to have cataract surgery can only be reached after you and your doctor discuss the benefits, risks, and alternatives. You also should discuss the possibility of having Advanced Technology Cataract treatment.

HOW DO I KNOW WHICH LENS TO CHOOSE?

When your cataract is removed, a new lens is placed inside of your eye. This makes cataract surgery an exciting time, because patients who had been nearsighted or farsighted can now be made to have excellent vision without glasses. 20 years ago all patients receive the same type of lens with their cataract surgery. Over the last 10 years manufacturing companies have developed new lens technologies. These lens options can give you additional benefits, but also more choices that need to be made in determining your lens implant type. Because of these multiple options there are 2 important things to consider when choosing the artificial lens to be used in your cataract surgery: the type of lens and the power of the lens. Choosing a cataract lens depends on many personal factors, including the activities do you do during the day and which ones would you like to do without glasses if possible? In addition, find out if you are able to pay extra money for a lens that does more than the standard lens covered by your insurance company? At what distances would you like to see most clearly without glasses – near (reading), intermediate (computer screen), or far (driving)?

Lens Options:

There are now many different lens options available to patients. You and your doctor will work together to determine the perfect lens for you. Currently, the following types of lenses are available…Standard lens (monofocal) – This high-quality, clear lens delivers excellent vision at only one distance. The focal point or distance at maximum clarity can be set to distance (driving, golfing, watching TV), intermediate (grocery store shelves, computer, car dashboard), or near (reading, hobbies). There is no extra out-of-pocket cost with a monofocal lens.

Multifocal lens – Designed to reduce your need for eyeglasses for both distance and near vision, this lens gives you clear vision at several distances. This is a special lens and is not fully covered by insurance so there would be an extra payment for this lens.

Toric lens – Designed to treat astigmatism and deliver excellent vision at a single distance. This special lens is also not fully covered by insurance.

Monovision – this implant technique uses a monofocal lens with a different power in each eye so that you don’t have to use glasses for most of your daily activities. Your dominant eye is generally set for distance, and the other eye is set for near. Many people successfully use monovision with contact lenses. Successful monovision requires cataract surgery to each eye.

Visual needs should also be considered when deciding on a multifocal lens. The technology contained in these lenses that allows you to read without glasses may lead to mild symptoms such as glare, halos, or decreased contrast sensitivity in certain conditions, such as night driving or dim restaurant lighting. Some patients rarely notice visual effects related to the lens implant. Others notice the effects but are not significantly bothered by them. If you feel you would not be able to adapt to these visual symptoms, you probably are not an ideal candidate for a multifocal lens. Motivation to not wear glasses should also be determined when selecting a multifocal lens. These lenses are designed for patients who are motivated to not have to wear glasses after their cataract surgery. Some patients are accustomed to wearing glasses and do not mind using them after surgery. The additional cost of a multifocal lens would not be a reasonable investment for these patients. For other patients, eliminating the need for glasses is a strong desire. Paying the additional out-of-pocket cost for a special lens would make much more sense for these patients, as these lenses would give them the best option to achieve their goal to be free from glasses.

PanOptix

If you have been diagnosed with cataracts, don’t wait for your vision to worsen before seeking treatment. Cataract surgery is one of the most commonly performed ocular surgeries in the world and has transformed the lives of countless patients. During cataract surgery, your clouded lens will be replaced with an artificial alternative referred to as an intraocular lens or IOL.

While there are many intraocular lenses on the market, few are as innovative as the AcrySof IQ PanOptix trifocal IOL. At Progressive Opthalmology, we are delighted to offer our Queens, NY Ophthalmology patients the newest and most innovative lens replacement solution – AcrySof IQ PanOptix lenses, which are available in both standard and toric variations.

With so many different lenses available in the United States, it can be difficult to decide which is the best for you. There are many qualities that make AcrySof’s PanOptix lenses stand out from traditional IOLs.

The PanOptix is the first and only trifocal lens in the United States. They provide patients with enhanced vision and clear, complete focus that is unrivaled by any other type of lens. Trifocals outperform other premium lenses. Like other multifocal lenses, trifocal IOLs have different sections set to alternating refractive powers. While standard multifocal lenses only have sections for distance and close-up vision, AcrySof IQ PanOptix IOLs have sections that create clear vision at all distances for far, intermediate, and close-up focus.