Our Board Certified Ophthalmologists have performed over 25,000 cataract operations, and below are some of the modern developments in cataract care:
What is a Cataract?
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A cataract is a clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or "fogged" with steam.
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There are many misconceptions about cataract. it is:
Common symptoms of cataract include:
The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present.
What is a Cataract?
The most common type of cataract is related to aging of the eye. Other causes of cataract include:
How is a Cataract detected?
A thorough eye examination by our eye doctors can detect the presence and extent of a cataract, as well as any other conditions that may be causing blurred vision or discomfort.
There may be other reasons for visual loss in addition to the cataract, particularly problems involving the optic nerve. If these problems as present, perfect vision may not be returned after cataract removal.
If such conditions are severe, removal of that cataract may not result in any improvement in vision. Our opthamologists can tell you how much visual improvement is likely.
How fast does a Cataract develop?
How quickly the cataract develops varies among individuals, and many may vary even between the two eyes. Most cataracts associated with aging progress gradually over a period of years.
Other cataracts, especially in younger people and people with diabetes, may progresss rapidly over a few months and cause vision to worsen. It is not possible to predict exactly how fast cataracts will develop in any person.
How is a Cataract treated?
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Surgery is the only way your opthamologist can remove the cataract. However, if symptoms from a cataract are mild, a change of glasses may be all that is needed for you to function more comfortably.
There are no medications, dietary supplements, excercises or optical devices that have been shown to prevent or cure cataracts.
When should surgery be done?
Cataract surgery should be considered when cataracts cause enough loss of vision to interfere with daily activities.
It is not true that cataracts need to be "ripe" before they can be removed. Cataract surgery can be performed when your visual needs require it. You must decide if you can see to do your job and drive safely, if you can read and watch TV in comfort. Can you perform daily tasks, such as cooking, shopping, yard work or taking medications without difficulty?
Based on your symptoms, you and your opthalmologist should decide together when surgery is appropriate.
What can I expect from Cataract surgery?
Over 1.4 million people have cataract surgery each year in the United States, 95% without complications.
During cataract surgery, which is usually performed under local anesthesia as an outpatient procedure, the cloudy lens is removed from the eye. In most cases, the focusing power of the natural lens is restored by replacing it with a permanent intracular lens implant.
Your opthalmologist performs this delicate surgery using a microscope, miniature instruments and other modern technology. The procedure is done through a tiny 3mm incision in the cornea.
With the modern Phacoemulsification method of removing a cataract, the hard center and its soft remnants are gently removed by suction, and the thin capsule or shell left in place. This maintains the natural anatomy of the eye and reduces the chance of complications associated with the older methods of cataract surgery.
After removing the clouded lens, your surgeon will then implant a foldable lens in the same place as the natural cloudy lens that was removed.
The procedure usually requires no stitches, although occasionally a stitch may be used. This tiny incision makes your recovery quicker and safer.
Although it is a common misconception, lasers are not used to remove cataracts.
In approxiametely one fifth of people having cataract surgery, the natural capsule that supports the intracular lens will become cloudy. Laser surgery is used to open this cloudy capsule, restoring the clear vision.
After cataract surgery, you may return almost immediately to all the most strenuous activities. You will have to take eyedrops as your opthalmologist directs. Several postoperative visits are needed to check on the progress of the eye as it heals.
Cataract surgery is a highly successful procedure. Improved vision is the result in over 95% of cases, unless there is a problem with the cornea, retina, or optic nerve. It is important to understand that complications can occur during or after the surgery, some severe enough to limit vision. As with any surgery, a good result cannot be guaranteed.
Cataract patients can now opt for high-tech replacement lenses to correct their reading vision as well as their distance vision during cataract surgery.
Dr. David Robinson, Medical Director of the Delaware Eye Institute, recently stated, "Here at the Delaware Eye Institute, Dr. Fred Cook, Dr. Charles Curry and I have performed over 25,000 cataract surgeries, and take advantage of all the latest technologies that we feel are safe and effective. These new FDA approved Intraocular lenses which also correct for reading vision represent the most recent advancement in lens design, and we look forward to making them available to our patients."
The new Medicare ruling permits patients to combine surgery for Cataract, a Medicare covered condition, and Presbyopia, a non-covered condition involving the loss of near vision and requiring aging patients to wear glasses. Medicare will still cover the cost of cataract surgery as usual, but patients can now choose to pay an additional out-of-pocket fee for the new lens implant if they wish to take advantage of this advanced technology.
Previously, patients were most often restricted to glasses as their only means of correcting reading vision after cataract surgery.
The FDA has approved three lens implants that use different technologies to allow patients to be less dependent on reading glasses. These include the ReSTOR lens from Alcon, the ReZoom lens from AMO, and the Crystalens from Bausch and Lomb.
In the FDA trials, up to 70% of patients never needed glasses after cataract surgery using these lens implants technologies. 20-30% of patients still needed glasses some or all of the time.
"We think these results are truly remarkable," continued Dr. Robinson, "but nothing is perfect. Surgeons are finding even more consistent results when enhancement procedures for astigmatism are performed. We plan to take a team approach here to optimize our results, working with Dr. John Wahl, our refractive surgeon who has performed over 5,000 LASIK procedures. Any necessary procedures such as corneal relaxing incisions or LASIK surgery enhancement after cataract surgery can be performed right here at our outpatient surgical facility. This will allow us to treat patients even if they have significant astigmatism, and fine-tune our results to maximize surgical outcomes."
As with any surgical procedure there are inherent risks, and results cannot be guaranteed. Patients are encouraged to obtain a comprehensive eye exam, and obtain more detailed information about potential risks and benefits to help decide whether cataract surgery and the new presbyopia lens implant technology is right for them.
"Cataract surgery continues to be one of the safest and most successful surgical procedures performed in the world. We look forward to leading the way towards greater freedom from glasses for our cataract patients," said Dr. Robinson.
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