Cataract Surgery and Premium Lenses

At our Memphis vision center, we invite senior citizens to visit us for a cataract consultation and our doctors can advise you further.

What Does Cataract Surgery Accomplish?

The lens of the eye is a transparent structure behind the pupil that focuses light rays coming into the eye. This structure generally becomes clouded as one ages, resulting in a gradual loss of vision. The clouded lens is known as a cataract and is the leading cause of vision loss in the United States. While it is difficult to prevent the development of cataracts, removing them surgically is a relatively simple procedure.

In cataract surgery, as the cataract (the opacified natural lens) is removed from the eye, a clear artificial lens (IOL – intraocular lens) is placed into the eye to replace the natural lens. The power of this lens is calculated by the surgeon to provide a certain refractive outcome and in contemporary cataract surgery, many patients with significant refractive error can expect to see better without glasses than they ever have in their life. Frequently, patients will become less dependent on their glasses as they can do most tasks such as driving or reading the newspaper without glasses. However, all patients, to see their best at distance and at near would need glasses with some type of bifocal or contact lenses with reading glasses. Patients with pre-existing astigmatism will still need to have their astigmatism corrected with glasses or contact lenses. It is also important to realize that there are limitations and that by calculating the lens power even with the most sophisticated of methods, there is still a margin of error that cannot be overcome with current technology.

How Is Cataract Surgery Performed?

During surgery, a small tunnel-like incision is made in the white part of the eye (sclera) at the edge of the corneal. The lens is then removed through a procedure known as phacoemulsification, in which an ultrasonic probe is used to break up the cataract and then suction out the remaining pieces. Once the cataract is removed, a new lens is inserted through the same incision by means of a tiny tube in which the lens is folded. Upon insertion into the lens cavity, the new lens unfolds into place.

LenSx® Laser
Revolutionary Advanced Option for Cataract Surgery

We are happy to offer bladeless laser cataract surgery, a precise computer-controlled option, at MECA. The LenSx® Laser enables our surgeons to customize the procedure to your eye. Integrated optical coherence tomography (OCT) captures high-resolution images of your eyes and provides measurements and data used to plan and perform a surgery to exacting specifications not attainable with traditional surgery.

In traditional cataract surgery, the surgeon uses metal surgical instruments and blades to make the incision and remove the cataract. With the LenSx® Laser a femtosecond laser adds high-resolution OCT mappings of your eye and computer-controlled steps that are customized with your measurements to plan and perform customized and precise incisions in cataract surgery.

After examining the health and measurements of your eyes your surgeon will be able to determine if this new advanced technological option is right for you.

The Refractive Component of Cataract Surgery

If your doctor recommends cataract surgery to improve your vision, you need to be aware of several optional procedures that are now available to enhance the refractive outcome of the surgery. Traditionally, cataract surgery was considered a way to restore clarity and the elimination of refractive error was a secondary goal. However, as techniques and technology have progressed, the refractive component of cataract surgery has become increasingly important.

The refractive component of cataract surgery involves the ability of the surgeon to correct pre-existing refractive errors at the time of cataract surgery. Refractive errors are the problems in vision that can be corrected by wearing glasses or contact lenses. There are four basic types of refractive error: myopia, hyperopia, astigmatism, and presbyopia. Myopia, or nearsightedness, refers to eyes that see better at near than distance. Hyperopia or farsightedness, refers to eye that see better at distance than at near. Astigmatism refers to eyes that have irregular shapes to their cornea causing distortion in images whether they are at near or at distance. Presbyopia refers to the loss of the ability to change focus of the eyes with age. Usually, presbyopia starts in the forties and requires people to wear reading glasses or add bifocals to their glasses.

Most often a Single Vision IOL is inserted into the eye at the time of cataract surgery. Careful preoperative measurements allow the physician to choose the correct power IOL for your eye to focus at a distance. Reading glasses or bifocals would be needed to see clearly to read.

Monovision or blended vision involves selecting intraocular lenses that will leave one eye focused for distance and the other eye focused at near. This allows you to be spectacle free for most tasks. This approach is best used on patients who have done this with contact lenses and know its limitations.

Astigmatism is irregular curvature in the cornea. The cornea is shaped more like a football instead of a basketball. A single vision IOL will not correct corneal astigmatism. There are two options for patients with small to moderate amounts of pre-existing astigmatism.

• Astigmatic Keratectomy or Limbal Relaxing Incisions. (AK or LRI) At the time of cataract surgery, the surgeon can make extra incisions in the cornea to decrease the amount of astigmatism. This technique is simple and generally decreases astigmatism to very small amounts depending on the pre-existing astigmatism.
• Toric IOL – IOL with the astigmatism built in. This lens will correct either at distance or near and astigmatism up to a certain limit. Although the toric IOL corrects the astigmatism portion of one’s prescription, it does not have the presbyopia/near correction available.

Multifocal IOLs have rings of different powers built in the lens surface. Depending on which ring you are looking through determines if you are seeing at near, intermediate or distance. These lenses are superior to the traditional monofocal lenses, but some patients notice an increase in visual symptoms such as glare and halos at night.

Treatment Details

The majority of our cataract surgeries are performed in our outpatient ambulatory surgery center on the second floor at MECA. Before surgery, patients are generally given a mild sedative to help them relax. In addition, the eye is topically anesthetized using eye drops. The patient is awake throughout the surgery and able to talk with the doctor. The surgery itself is a relatively simple procedure and takes less than 30 minutes. Patients are not greatly restricted after surgery in terms of their everyday activities. However, for a few days the patient is advised not to engage in overly strenuous activity or any activity that may subject the eye to trauma.

The eye may appear red and irritated for a few days after surgery, but the patient should not experience pain. Patients will return to our office for a follow-up visit the morning after surgery to make sure that the eye is healing properly and to discuss any concerns the patients may have. Vision may be blurred for the first few days after surgery, but will gradually improve and most patients find that they are able to see without glasses better than they ever could before. However, cataract surgery may not completely correct vision, especially if there is another underlying eye disease and the use of reading glasses or bifocals may be prescribed by your physician.

Frequently Asked Questions about Cataract Surgery

Can cataracts be avoided?

Because most cataracts are caused by age-related changes to the eye, there is no surefire way to avoid them. When caught early by an eye doctor, it may be possible to slow the development of cataracts with lifestyle changes like eating a nutritional diet, not smoking, keeping health conditions like diabetes under control and protecting the eyes from the sun.

Is cataract surgery safe?

Cataract surgery is the most commonly performed surgical procedure in the country and is very safe. The surgeon’s experience affects the degree of risk. The more experienced the surgeon, the lower the risk of complications.

Can both eyes be treated at the same time?

Technically yes, both eyes can be treated on the same day. However, another approach is to treat one eye, wait a few weeks and then treat the second eye. This allows one eye to recover and vision to stabilize before treating the other eye.

Is laser cataract surgery safer than traditional cataract surgery?

Laser cataract surgery improves upon the already safe traditional cataract removal procedure. By replacing handheld blades or instruments with a sophisticated laser, the procedure eliminates some of the possibility of human error and automates parts of the procedure for safer and more precise results.

Does cataract surgery hurt?

No. You should experience very little (if any) discomfort during the procedure. You will be given a mild sedative to help you relax, and your eyes will be numbed with special drops.

 

Will I be awake during cataract surgery?

Yes. But you will feel very relaxed and feel little to no discomfort.

Will I need to wear glasses after cataract surgery?

It depends on the type of IOL that you choose to have placed. You may opt for a standard monofocal lens that restores clear vision at a single distance; in those cases, you will likely need to wear glasses to see clearly up close. However, you also have the option of multifocal lenses, which restore clear vision at multiple distances, virtually eliminating the need for glasses after surgery.

How much does cataract surgery cost?

The cost of cataract surgery depends on factors such as the surgeon performing the procedure, the type of procedure performed and the type of IOL used. Laser cataract surgery usually costs a little bit more than traditional cataract surgery, and the more advanced types of IOLs are a little more expensive than standard monofocal lenses.

Can I have cataract surgery after LASIK?

Yes; having LASIK does not preclude you from having cataract surgery. The procedures treat different parts of the eye. It’s recommended that you give your cataract surgeon your complete medical records, which contain information that may be helpful when planning cataract surgery.

Can I have cataract surgery if I have glaucoma?

It is certainly possible to undergo cataract surgery if you have glaucoma. There is a chance that cataract surgery can lower your intraocular pressure and reduce or eliminate your need for glaucoma medication. The cataract surgeon may also be able to perform a type of glaucoma surgery at the time of cataract surgery. With that in mind, you will be carefully monitored after cataract surgery to watch for any spikes in intraocular pressure and other complications.

Contact Our Memphis Cataract Surgeons

In summary, cataract surgery has progressed to the point where outcomes are better than ever, and the vast majority of patients are very pleased with the results. Today there are additional options that should be considered prior to cataract surgery. We want our patients to be well educated on their options so that they can make the best-informed decisions regarding these options. The doctors and staff of MECA look forward to seeing you and will be ready to answer any questions you might have.