The lens of the eye allows light to be focused on the retina in order to have good vision. As we age the lens becomes cloudy and, similar to having smudges on your glasses, the image gets blurry. When this occurs the cloudy lens is called a cataract. This can affect your daily activities such as driving or reading. The only way to improve or restore your vision when this occurs is to remove the cloudy lens and replace it with a clear artificial lens. This is done with cataract surgery—one of the most common and safest surgeries performed in the United States.
Cataracts usually develop slowly. When they initially start, most people do not notice the slight loss of vision. Some can lose a large amount of their vision prior to noticing the symptoms. In fact, when doctors remove the cataract in these patients they are often amazed at how much vision they were missing.
Cataracts can also cause other symptoms, such as significant glare and haloes. Patients often notice increased glare with oncoming headlights at night, which causes these patients to have difficulty driving safely. Patients will also notice colors are not as sharp or vibrant as they once were.
Initially, a change in your glasses may improve your vision. If this does not help, cataract surgery is the ultimate solution. Cataract surgery is a simple, relatively painless procedure to regain vision. It is one of the most common surgical procedures performed in the United States, with more than 3 million Americans undergoing cataract surgery each year. Not only is it one of the most common surgeries performed in the U.S., it is also one of the most successful operations performed with most people regaining excellent vision.
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Cataract surgery is a relatively simple procedure performed on an outpatient basis, meaning you will not be staying in the hospital. In the early days of surgery, patients were put to sleep or were placed under anesthesia with a needle to the eye. This technology has improved significantly — we now use “eye drop” anesthesia in which no needles are used and the patient is awake with no discomfort during the procedure.
The surgeon uses a blade to make a very small incision in the eye. The cloudy lens is then broken up using a procedure called phacoemulsification. This device uses ultrasound energy to break up the cataract into multiple small pieces. This is similar to a pneumatic drill breaking up concrete into small pieces. The cataract remnants are then removed from the eye.
After all remnants of the cloudy lens have been removed from your eye, the cataract surgeon inserts a clear intraocular lens, positioning it securely behind the iris and pupil, in the same location your natural lens occupied.
Stitches are not commonly used in this surgery. Patients are capable of walking out from the surgery and can typically resume most of their daily activities that same day.
Just like LASIK surgery, numerous advances in laser technology have been applied to cataract surgery. One of the most recent and dramatic is the use of a femtosecond laser instead of a high frequency ultrasound device to break up the cataract. These lasers offer the advantages of doing the surgery without the use of any blades entering the eye and instead implements laser precision cuts. This method is known for reducing astigmatism and safely breaking the up the cataract without entering the eye.
After the cataract is removed from the eye, artificial lens implants (IOLs) have to be inserted. Otherwise, patients would have to wear high-powered “Coke bottle” glasses afterwards. IOLs have been around since the mid-1960s, though the first FDA approval occurred in 1981.
Standard or monofocal lens implants offer clear vision at only one distance, usually distance vision. This mean that you must wear eyeglasses or contact lenses in order to read, use a computer or view objects at arm’s length.
New lens technology makes it possible for cataract surgery to help improve both near and distance vision. These new multifocal lenses offer the possibility of seeing well at more than one distance, without glasses or contacts. These lenses offer patients the possibility of using no glasses after cataract surgery.
Presbyopia-correcting IOLs are considered “premium” lenses, which means that you must pay any associated extra cataract surgery costs yourself. Medicare and most health care plans will not cover these extra costs, because the additional benefits of these IOLs are considered a luxury and not a medical necessity.
Types of intraocular lens implants available at Atlanta Vision Institute include:
Monofocal lenses are the standard IOLs covered with Medicaid, Medicare and private insurance. These lenses are set to focus at just one focal distance for near, intermediate or distance vision. Monofocal lenses are commonly adjusted for distance, so you can see clearly when looking far away but will require reading glasses for presbyopia and nearsightedness.
Multifocal IOLs are premium lenses that offer better vision at two focal points: near and distant. The synthetic lenses are adjusted for different zones and powers. A multifocal lens may improve blurry near vision caused by presbyopia, but some patients still require reading glasses. AcrySof IQ ReSTOR and Tecnis Multifocal are both FDA-approved multifocal IOLs.
Accommodative IOLs include Crystalens and Trulign Toric lenses, and these premium IOLs are designed to move and function like your eye’s natural lens. The lens changes shape inside your eye, much like a film camera lens, so that you can adjust and focus at various distances. Accommodative lenses treat all refractive errors, including presbyopia.
Trifocal IOLs are the most advanced IOL option available. AcrySof IQ PanOptix is the only FDA-approved trifocal IOL, and it offers the best visual range with little to no need for corrective eyewear after cataract surgery. PanOptix corrects for all focal distances and refractive errors. Dr. Ashraf prefers this IOL with our LaserOptix™ procedure that improves traditional cataract surgery by using a femtosecond laser to create the incisions in the lens capsule instead of a handheld blade. PanOptix with LaserOptix™ provides optimal safety and precision and the best visual result.
Toric IOLs designed to correct astigmatism also are considered “premium” lenses, and — like multifocal and accommodating IOLs — will likely cost extra because of the benefits that are unavailable in conventional IOLs.
Recovery from cataract surgery is quick and predictable. After your procedure is complete, you will be given special eye drops to decrease inflammation and protect against infection. Your eye will be bandaged with a protective patch or shield that you can remove at home, but will wear when sleeping. Your vision should be clear enough to allow you to resume daily activities in a few days. This includes driving, although you may notice some temporary sensitivity to bright lights. For the first week you should avoid bending, heavy lifting, and other vigorous physical activity.
As your eyes heal, it is important that you keep your follow-up appointments with experienced Atlanta ophthalmologist Dr. Farooq Ashraf. He will monitor your progress regularly, beginning the day after surgery. This helps him determine when cataract surgery can be scheduled for the second eye and to check for potential complications, including infection, excessive inflammation, hemorrhaging and retinal detachment.
The good news is that serious complications with cataract surgery are extremely rare. This is especially impressive given the fact that cataract procedures are among the most common surgeries in the world. More than 20 million are performed annually worldwide, including nearly 4 million in the U.S.
Generally, cataract procedures take under an hour. After your procedure, we will observe you for any complications. Most people can return home the same day.
You should expect your eye to fully heal in about eight weeks.
This varies from person to person. Before you start driving again, we recommend Dr. Ashraf first assesses your vision and clarifies that it is OK for you to do so.
In the vast majority of cases, patients remain awake throughout the procedure to ensure their eyes remain still. However, your eye will be completely numb the entire time. Most people experience little or no discomfort during cataract surgery – usually no more than some gentle pressure.
Yes! Of the over 3 million cataract procedures performed each year in the United States, over 98 percent are successful. Although complications can occur, they are uncommon and can almost always be fixed with follow-up procedures. With Dr. Ashraf’s skill and experience, there is no cause for concern about your safety during your cataract surgery.
Medicare covers standard cataract surgery, which means we use no lasers and implant monofocal lenses. If you wish to have laser cataract surgery or get premium lenses, you must cover the cost yourself.
The only way to treat a cataract is to remove the cloudy lens and replace it with an artificial intraocular lens (IOL) via surgery. There are several different types of IOLs that can be used, depending on the shape of the eye, eyesight goals, and the patient’s insurance plan.
No matter what your needs are, the Atlanta Vision Institute can give you the sharp, clear vision you need and deserve. Dr. Ashraf is ready to help you through your cataract surgery, answering all your questions before, during, and after your procedure. His 22-year career and an extensive list of credentials are proof that when you choose Atlanta Vision Institute, you are choosing the highest quality eye care attainable.