laser surgey 1One of the few things guaranteed in life is: if we all live long enough, we will get cataracts. They are just a natural part of aging. Fortunately they are easily treated in the hands of an expertly trained surgeon.

Our Board Certified Ophthalmologists have performed over 30,000 cataract operations and are leaders in providing the latest technology for our patients. Below are some of the modern developments in cataract care:

  • Small incision or No-Stitch surgery shortens recovery time
  • Many patients return to normal levels of activity in a day or two
  • No need to go to the hospital for surgery
  • Surgery is done in our Outpatient Surgery Center


Delaware Eye Institute has three Cataract Surgery Specialists

ORA OptIWAVE Refractive Analysis

cataractsWe are proud to be the first facility on Delmarva to feature the ORA System as a part of our cataract treatment technology at Delaware Eye Institute. This revolutionary system is the first of its kind to gather data from no-contact intraoperative wavefront aberrometry during cataract surgery. Using this information, our ORA System helps us select intraocular lenses, or IOLs, that match a patient’s precise needs regarding lens power, magnitude and axis of astigmatism, and aphakic and pseudophakic measurements.

With this system we are finding our predictability results for obtaining the correct IOL power are dramatically increased. Dr. Robinson commented “this system is a tremendous advantage over our previous methods of calculating IOL power.  With real time measurements during surgery, especially for our TORIC IOL patients with astigmatism, we have a definite advantage in trying to meet our patient’s goals. I recommend it to all our patients. If I, or my family members, were having cataract surgery I would insist on my surgeon use the ORA System intraoperatively.

As with any eye care procedure, it is of paramount importance that we establish an open line of communication with each patient to develop a plan to meet his or her goals. We think these results are truly remarkable," continued Dr. Robinson, "but nothing is perfect. Many patients may still need glasses for their best vision after surgery. It is also 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.”

New Intraocular Lens Technologies

iol-technologies-largeDr. David Robinson, Medical Director of the Delaware Eye Institute, recently stated, "Here at the Delaware Eye Institute, our cataract surgery specialists have performed over 30,000 cataract surgeries, and take advantage of all the latest technologies that we feel are safe and effective.

Medicare now 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 also permits patients to combine surgery for astigmatism using TORIC intraocular lenses as well. 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 new types of intraocular lens implants if they wish to take advantage of this advanced technology.

In the FDA trials, improved vision was noted in over 95% of cases, with up to 60% of patients never needing glasses after cataract surgery using these lens implants technologies. However, 20-40% 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. Many patients may still need glasses for their best vision. It is also 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 FAQs

What is a Cataract?

cataract-retinaA 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.
There are many misconceptions about cataract. it is:

  • Not a film over the eye;
  • Not caused by overusing the eye;
  • Not a cancer;
  • Not spread from one eye to another;
  • Not a cause of irreversible blindness.

Common symptoms of cataract include:

  • A painless blurring of vision;
  • Glare, or light sensitivity;
  • Frequent eyeglass prescription changes;
  • Double vision in one eye;
  • Needing brighter light to read;
  • Poor night vision;
  • Fading or yellowing of colors.

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 causes a Cataract?

The most common type of cataract is related to aging of the eye. Other causes of cataract include:

  • Family history;
  • Medical problems, such as diabetes;
  • Injury to the eye;
  • Medications, such as steroids;
  • Cigarette smoking;
  • Long-term, unprotected exposure to sunlight;
  • Previous eye surgery.
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 are 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 ophthalmologists 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 progress 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?

Surgery is the only way your ophthalmologist 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, exercises 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 ophthalmologist should decide together when surgery is appropriate.

What are Intraocular Lenses (IOLs)?

When your cataract (cloudy human lens) is removed, it is alike to a camera taking a photograph without a lens; the photo would be blurry. Therefore, anyone undergoing cataract extraction receives a new, man-made lens, called an intraocular lens (IOL), to replace their natural lens.

IOLs are permanent and maintenance free. You cannot feel them, you will never have to clean them, and unlike your natural lens, they stay clear indefinitely. The size, shape, design, material and prescription will be chosen by your doctor especially for you.

What are the different types of IOLs?

After a thorough examination and evaluation, you will be presented various options of IOLs. These IOLs are specially designed for you based upon your doctor’s recommendation and your lifestyle. An IOL counselor will assist you with a detailed explanation of your lens options and answer any questions that you may have.

A Monofocal IOL is a lens that assists patients for distance activities, making patients less dependent on glasses for activities such as driving, going to the movies, and watching TV.

Advanced Technology IOLs (AT IOLs) offer variable distance viewing with greater possibility that glasses or contacts will not be needed. They often can provide less dependence at all distances and offer greater freedom from eyewear than traditional monofocal IOLs.

Toric IOLs reduce or eliminate corneal astigmatism and greatly improve distance vision without the need for corrective lenses.

An Accommodating (Crystalens) IOL is a revolutionary lens design that changes focus as the patient views objects at varying distances. The Crystalens is controlled by the same eye muscles that would control a natural human lens.

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 intraocular lens implant.

Your ophthalmologist performs this delicate surgery using a microscope, miniature instruments and other modern technology. The procedure is done through a tiny 2.85 mm 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 approximately 20 percent of people having cataract surgery, the natural capsule that supports the intraocular lens will become cloudy over time. Laser surgery is used to open this cloudy capsule, restoring the clear vision.

After cataract surgery, you may return almost immediately to all normal activities with the exception that you will be asked to avoid swimming for a few weeks after surgery. You will have to take eye drops as your ophthalmologist 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 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.