Cataracts

What is a cataract?

 

The term Cataract is used to describe a natural lens that has turned cloudy.  Cataracts are not a disease, but rather a condition affecting the eye.  As the natural lens of the eye becomes cloudy, it does not allow light to pass through it as well as it did when it was transparent.  Cataracts usually start as a slight cloudiness that progressively grows more opaque.  They are usually white, but may take on color such as yellow or brown.  As the cataract becomes more mature (increasingly opaque and dense), the retina receives less and less light.  The light that does reach the retina becomes increasingly blurred and distorted.  This causes gradual impairment of vision.  If left untreated, cataracts can cause blindness.  A cataract can only be removed by surgery.

 

What are the symptoms of a cataract?

 

  • A gradual deterioration in vision over time

  • Objects may appear yellow, hazy, blurred or distorted

  • Vision at night or in low light conditions may be reduced

  • Vision in bright light or in the sun may be difficult due to glare

  • Halos may appear around bright lights at night

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cataract Surgery is one of the most common operations performed, usually with excellent results.  Generally, cataracts are removed on an out-patient basis.  Most patients could be up and about on the day of surgery, but we encourage our patients to rest their eyes as much as possible.

 

What causes Cataracts?

 

Cataracts develop for a number of reasons, but the most common cause is aging.  These Age-related cataracts develop as a result of natural changes within the lens.  In other cases, an injury or blow to the eye may cause a traumatic cataract. Some cataracts may also result from the use of certain drugs, exposure to harmful chemicals or excessive amounts of ultraviolet radiation, or some diseases.  Cataracts are typically slowly progressive but can be rapid in some cases.   In addition, some babies are born with congenital cataracts as a result of unusual prenatal factors.  Some cataracts are simply inherited.  Fortunately, Dr. Weir is able to remove almost all cataracts and restore vision through modern microsurgery.

How are Cataracts Treated?

 

Surgery is the only way to improve blurry vision and glare that is due to a cataract.  There are no medications, eye drops, exercises, or glasses that will cause cataracts to disappear or to prevent them from forming.  When cataracts interfere with your vision so that you are no longer able to see well enough to do the things you like to do, cataract surgery should be considered.   Cataract surgery is a pain-free experience thanks to advances in anesthesia.  Patients are numbed with eye drops, not needles, and are peacefully awake during the surgery. 

Advances in “No-Stitch” Cataract Surgery

 

The surgery is a modern, out-patient procedure.  The stay at an ambulatory surgical center is just a few hours and recovery time after surgery is dramatically reduced.  Many people enjoy improved vision with minimal dependence upon corrective eyewear as a result of modern cataract surgery.

 

RLE or Cataract surgery is a pain-free experience thanks to advances in anesthesia.  Patients are awake during the surgery and are able to resume most activities shortly afterwards.

 

Your lens will be removed with an advanced technique called phacoemulsification, or small-incision cataract surgery.  After applying a local anesthetic, a tiny incision of about 1/8” is made in the front part of the eye.  The natural lens is then broken into microscopic particles using ultrasound waves and gently suctioned from the eye.  Then, to compensate for the removal of the natural lens, an intra-ocular lens (IOL) is implanted into the eye.  This type of incision is self-healing, stronger and remains tightly sealed by the natural outward pressure within your eye.

 

Once removed, cataracts will not grow back.  However, some patients may experience clouding of a thin tissue called the capsule or “bag” that holds the intra-ocular lens (IOL).  If this occurs, a YAG laser is used to painlessly open the clouded capsule and restore clear vision.

 

“Intraocular Lenses” (IOLs)

 

Intraocular Lenses or IOLs, are small lenses made of a soft polymer (Silicone or Acrylic) and are implanted inside the eye in place of natural lens. Intended to replace the eye's natural lens following cataract removal, intraocular lens implants (IOLs) are becoming increasingly functional, and the technology involved in this amazing treatment is constantly evolving.   Premium Presbyopia Correcting IOLs offer patients the opportunity to restore their ability to focus at distance and up close without having to depend on reading glasses after cataract surgery. Southwest Eye Clinic is proud to offer an impressive selection of lens replacement options, including revolutionary ReSTOR and Crystalens premium multifocal implants. If you are interested in learning more about refractive lens implants and how they can help to restore your visual acuity, please contact Southwest Eye Clinic today.

 

RLE (Refractive Lens Exchange)

 

RLE and cataract surgery are essentially the same procedure. In both procedures, the natural crystalline lens of your eye is removed through a small incision made in your eye and replaced by a man-made Intraocular Lens implant or IOL. The only difference is that RLE is a totally elective procedure done to decrease the need for glasses, while also eliminating existing early cataracts.  Removing the cataract in cataract surgery is done for medical reasons such as blurred vision, glare, or seeing haloes. This procedure is advantageous to those over 45, that may have the early starts of cataracts, or are not ideal LASIK candidates.

 

How do I know if I am a candidate for RLE or cataract surgery?

 

You may be a candidate for Refractive Lens Exchange if you:

  • Over the age of 45 and having difficulty focusing on objects up close.

  • Do not qualify as a candidate for laser vision correction, (i.e. LASIK), because you are either too farsighted or too nearsighted, have thin corneas or severe dry eye

  • Tired of wearing bifocals or progressives to correct your reading and distance vision

  • If you already have cataracts starting to form, RLE may make a lot of sense. If you are already presbyopic, RLE may be a better alternative. There is little need to have surgery affecting the cornea if within a short period of time you will be having cataract surgery anyway or you already cannot change focus from distance to near.

 

How is RLE or Cataract Surgery Done?

 

  • RLE surgery is performed the same way as cataract surgery.

 

IOL Calculation with the IOL MASTER

 

IOLs come in different sizes and configurations. In order to choose the best type of IOL, a measurement is a performed. The length of the eye is determined with an A-Scan, the same type of equipment used in fetal ultrasound-only on a much smaller scale. Southwest Eye Clinic uses the most modern ultrasound device available, the IOL Master because minute differences in the measurement have a substantial impact on the IOL calculation.

 

Despite the wonderful advances with cataract surgery, it is also important to realize that the main goal of cataract surgery is to make you see better. Every effort will be made to reduce or eliminate your need for glasses; however, some patients will still need to use vision correction. It is important to realize that a 0.3 mm difference in A-scan measurement is equals to one diopter of glasses refraction. To put that measurement in context, 0.3-mm is less than the thickness of the letters on this page. Southwest Eye Clinic uses IOL Master, the most precise and finest technology for A-scan measurement to provide you the best possible care.

 

Premium IOL Implants

 

At Southwest Eye Clinic, we are always excited to introduce new, breakthrough technologies to complement the extensive range of vision correction procedures.  As a leading corneal specialist, Dr. Kurtis Weir is continually investigating the latest, most promising advances in vision restoration, integrating the most effective of these into his practice.

 

Cataract surgery has undergone tremendous technological advances since the days of your parents and grandparents.  The good news is that you've encountered cataracts at a time when intraocular lens technology has taken a giant leap forward.  No longer is the objective to simply restore your distance vision with a monofocal IOL.  Today, the goal is to enhance your vision, thus minimizing your dependence on glasses, including reading glasses or bifocals. 

 

For most cataract and RLE patients, life without reading glasses or bifocals is something they either experienced before presbyopia or they just dreamed about for most of their lives.  But today, premium IOLs such as ReStor and Crystalens are turning those dreams into reality with revolutionary lens technology, which is designed to allow patients to see clearly at all distances without bifocals or reading glasses.

 

What is Presbyopia?

 

Presbyopia is an inevitable age-related eye condition that makes it difficult to read or see objects up-close without the use of reading glasses. Presbyopia is the first sign of cataracts and is the most prevalent eye condition in America. It causes the crystalline lens to increasingly stiffen, lose flexibility and cloud, diminishing its focusing ability.

 

Multifocal IOLs ReSTOR® Aspheric

 

The AcrySof ReSTOR Aspheric IOL (intraocular lens) gives people the ability to see near, far or in between, often freeing people from the need for glasses. Cataracts aren't uncommon; they're a natural part of the aging process for many people. Previous IOLs used to replace cataracts were either limited to middle-vision or monovision, meaning a person could only see in the middle ranges or had to have one eye focused for near and the other for distance vision.

 

The ReSTOR lens is revolutionary because it is a permanent lens that provides for the full range of vision with little or no need for glasses or other corrective lenses. After anesthetic eye drops have been applied to the eye, the surgeon makes a small incision. An instrument is then used to dissolve the clouded lens and the ReSTOR lens is inserted. Because no stitches are used and the eye heals itself, the procedure is virtually pain free and recovery is fast.

 

This lens is revolutionary because it allows for all-distance vision. It is tapered from the center to the outside to allow a smooth transition of light, be it from near, far or in-between focal points. After surgery, four out of five patients reported never wearing glasses. And 94% were so satisfied that they'd do it all again. 

 

Crystalens HD - the Accommodating or "Focusing" IOL

 

Crystalens HD IOL

Are you tired of wearing bifocals and reading glasses? Southwest Eye Clinic has the solution for you!

Introducing Crystalens New surgical technology at Southwest Eye Clinic, Crystalens can restore good vision to most people who wear bifocals and reading glasses. Today, you may be able to see near, far and everywhere in between — as well as you did in your 20s and 30s. Read the newspaper, work on your computer and look off in the distance — all without the need for glasses, bifocals or contact lenses.

 

Previous generations of intraocular lenses were not capable of responding to your eyes' muscles and could only provide you with a single-distance focus. Consequently, glasses or contact lenses were necessary for near or middle vision. Or during your Cataract surgery, your doctor had to focus one of your eyes for distance-vision and one for near-vision. Crystalens will give you a full range of vision by responding to your eyes' muscles and moving accordingly without glasses or contact lenses. Your eyes could focus at near, arm-length, or far distances.

 

The two-year FDA clinical study of Crystalens reported:

 

  • 100% of the patients could read newsletters without glasses or contact lenses,

  • 98% passed the driving test without glasses, and

  • 92% could see 20/25 or better at distant.

 

Can you correct my Astigmatism?

 

AcrySof® Toric IOL for Astigmatism

Until recently, cataract sufferers with astigmatism had few options for restoring vision back to a level that eliminates glasses or contacts from everyday life. Now, there's an intraocular lens (IOL) that has been created specifically for individuals with astigmatism. This advanced technology is called the AcrySof Toric Lens, and it has the power to deliver excellent all-around vision, including distance.

 

Benefits

 

  • Great results: can provide the freedom to see without glasses or contacts

  • Effective: specifically designed for astigmatism (up to -6.00D)

  • Maintenance-free: permanent solution to annoying contact lenses

  • Invisible: after it is implanted, it cannot be seen by the naked eye

  • Minimally invasive: implanting is fast and virtually painless

  • Biocompatible: made from Collamer, a highly biocompatible copolymer

 

Effectiveness

 

In recent FDA trials, patients implanted bilaterally with Toric IOLs reported the following:

 

  • 97% were able eliminate the need for glasses to see at distance

  • 97% achieved vision of 20/25 or better

 

Limbal Relaxing Incisions (LRI)

 

If appropriate, Dr. Weir may perform limbal relaxing incisions (LRI) to treat low to moderate degrees of astigmatism in conjunction with cataract surgery. Dr. Weir makes small relaxing incisions at the very edge of the cornea (in the limbus), which restores the cornea to a more spherical shape when it heals reducing visual distortions associated with astigmatism and potentially improving the patient's uncorrected vision.  LRI is one of several procedures Dr. Weir can combine with laser vision correction procedures and cataract surgery as part of a comprehensive vision restoration plan.

 

New Medicare Policy

 

Seniors Have Access to ReSTOR, ReZoom™, and Crystalens Premium Lens Technology at Southwest Eye Clinic   

Seniors on Medicare now can choose the premium presbyopia-correcting  ReSTOR, ReZoom™, and Crystalens lenses, which treat two conditions: cataract removal with lens replacement (a procedure covered by Medicare) and presbyopia (a non-covered service). Patients who select premium multifocal IOLs will receive the standard Medicare reimbursement for cataract surgery, and can now pay privately for the presbyopic portion of their treatment.

 

“This Medicare policy change means that patients now have a choice in their vision correction that best suits their individual lifestyle. It also gives us the option of offering premium IOL technology for improving both vision and lives for our Medicare patients,” says Dr. Kurtis Weir.

 

To find out if you're a candidate forReSTOR, ReZoom™, or Crystalens, call today at (913) 897-9200.

 

Your RLE or Cataract Surgery Experience

 

1) Pre Operative Surgery Care

During your preoperative examination, Dr. Weir will help you decide which IOL implant type and power is right for you and your lifestyle.   There are two types of IOLs; each is designed for a specific type of function.  Monofocal lenses provide correction in one segment of your visual range, whereas Multifocal lenses such as the ReStor, ReZoom™, and Crystalens lenses are available to correct your distance and near vision. Intraocular lenses are made out of inert materials acrylic or silicone materials and should last indefinitely. They have been safely implanted for over five decades!  Dr. Weir and the staff will then discuss the risks, benefits, complications, and alternatives of surgery. They will answer all of your questions and do their best to alleviate all of your concerns.

 

2) On the Day of Your Surgery

You need to arrive at the outpatient Deer Creek Surgical Suite no later than 45 minutes prior to the procedure. This affords the staff sufficient time to get you prepared for the procedure. You are given drops to dilate the eye and medications for relaxation. Cataract surgery usually takes about 10-15 minutes, but patients should expect to be at the facility for about one or two hours.

 

An anesthesiologist will be present during cataract surgery to administer intravenous medication through an arm vein to help you be comfortable. In addition, anesthetic drops are placed in the eye to eliminate pain or discomfort. This is called “topical anesthesia.”  In some instances, a local injection, or (Peri-Bulbar Block) is given that numb the area of the eye and prevent movement during surgery.

 

3) The Procedure

Cataract surgery is one of the safest, most effective types of surgery.  It is also one of the most successful.   Cataract surgery is safe and effective and is performed in our Deer Creek Surgical Center outpatient location. During cataract surgery, the cloudy natural crystalline lens is removed and replaced with an implant or intraocular lens or (IOL). 

 

Cataract surgery is performed with an operating microscope that magnifies the image of the eye, giving Dr. Weir the ability to remove the cataract with precision.  After adequate anesthesia is administered to calm and relax the patient, a small 2-3mm incision is made in the cornea.  This incision is so small that it seals without sutures in 99% of cases.   A round opening, a capsulorhexis, is made in the outer coating of the lens (the lens capsule). He will then use the newest Alcon Ozil phacoemulsification technology which is an ultrasound vacuum to remove the clouded cataract in a precisely controlled manner from its outer shell called the capsule.  After all of the inner lens components are removed, there is an empty capsular bag.

 

The intraocular lens implant (IOL) is then inserted into the capsular bag providing a clear focusing pathway for light and is intended to stay in the eye forever.. This implant is carefully calculated by Dr. Weir using the IOL Master and tailored to each patient's needs, nearsightedness and farsightedness can be corrected at the same time as the cataract is removed thereby significantly reducing or eliminating the need for glasses.  Since the incision remains small, there is no need for stitches or a patch at the conclusion of the surgery. 

 

Since Dr. Weir is also a LASIK refractive surgeon, he strives to obtain the best possible vision for his patients without glasses in every case. 

 

4) Lens Replacement

Traditionally, lenses used in cataract surgery have been monofocal, allowing the user to see well at a single distance. Patients with monofocal lenses generally choose to have their natural lenses replaced with lenses that allow them to see well at distance and wear reading glasses for up close or intermediate work. Recent advancements in lens implant technology, however, have resulted in the development of multifocal implants or accommodating lenses.  These exciting new style lenses allow the patient to focus at different distances, giving good distance vision, plus improvement in intermediate or near vision. RLE can minimize your dependence on reading glasses or bifocals, but even with the newer multi-focal or accommodating lenses, glasses may be needed in certain situations.

 

5) After Cataract Surgery

After the procedure, you'll be given a short time to rest.  Then, the same day, you can go home.  Within the next 24 hours, your doctor will probably want to see you for a post operative examination.  Drops will be prescribed against infection, inflammation and pain to help your eyes heal.  For a couple of days, you may need to wear a clear protective shield at night to protect you from rubbing or bumping your eye.   You will be given specific post operative cataract surgery medication schedule to use over the next month.

 

As one of the nation's most respected and accomplished corneal specialists, Dr. Kurtis Weir modern microsurgical techniques provide for a true modern day miracle, that restores sight to most cataract patients. It is no longer necessary to give up activities such as reading and driving due to cataracts.  Over the past twenty years, Dr. Weir has performed over 20,000 Laser refractive, and cataract procedures. Through ongoing training in the latest techniques and a commitment to using only the most current technologies, Dr. Weir is able to perform cataract surgery that is entirely focused on the comfort and ultimate satisfaction of his patients.

 

YAG Laser Posterior Capsulotomy

 

Some patients will develop clouding of the capsular bag in which the lens was inserted. This is called posterior capsular opacification which occurs in about 30% percent of patients usually months to years after the original cataract surgery. The usual symptoms are diminished visual acuity or glare.

 

Posterior capsular opacification is easily remedied with a brief, painless laser treatment. The laser treatment is called a YAG capsulotomy. This procedure is performed in the office and takes about five minutes. Patients can return to full vocational and recreational activities immediately.  The procedure is actually among the safest and most consistently effective in all of ophthalmology, with complications occurring in less than 0.5% of patients.

 

What to Expect in the first month

 

  • White residue in corner of eye.  This is due to the Prednisolone drops & is normal

  • Fluctuating vision with progressive clearing over the next few weeks

  • Minor discomfort:  dryness, mild ache or scratchiness

  • Your old glasses may not be right – if necessary, new glasses will be prescribed by your Optometrist or by us at your one month visit

 

Restrictions

 

  • Wear protective sunglasses outside

  • Driving may be resumed when you feel confident, safe & the vision meets requirements

  • All other normal daily activities may be resumed.

Types of Cataracts

 

  • Nuclear Sclerotic Cataract – This is the most common type of cataract that occurs with aging. The natural lens becomes more dense and yellowish brown in the nucleus, or center of the lens.

  • Cortical Cataract – This type of white –grey cataract forms in the lens cortex, gradually extends its spokes from the outside of the lens to the center.

  • Posterior Sub Capsular Cataract (PSC) – This type of cataract may occur at younger ages than nuclear sclerotic cataracts.  A PSC is an opacity on the back surface of the lens. Patients with diabetes, radiation treatment, and trauma are more prone to develop this type of cataract. 

  • Combined– Often cataracts are a combination of those listed above

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