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Cataracts

What is a Cataract?

 

A cataract is a cloudy lens inside the eye. The lens is located just behind the iris (colored part of the eye). Cataract formation is a normal part of the aging process, but may occur at any age.  As we get older, our lens becomes more opaque, decreasing the ability of light to enter the eye. Light becomes scattered by the lens, often causing glare problems in our vision. In addition to aging and genetic predisposition, the development of cataracts has been associated with certain conditions like diabetes, inflammation in the eyes, trauma, and ultraviolet exposure from the sun.

 

What symptoms will I have?

 

The most common early symptom of cataract formation is glare, especially while driving at night. Oncoming car headlights may form a starburst pattern, and halos may be seen around street lamps. Colors will slowly become less brilliant and distinct, and white objects may appear somewhat yellow. Vision will eventually become blurred, and eyeglasses may need to be changed more frequently.

 

What are the treatment options?

 

The only treatment for cataracts is the surgical removal of the lens from the eye. The cloudy lens is replaced by a clear plastic or silicone lens implant. There are no proven medical treatments that will dissolve cataracts, and if left alone, they will usually become more yellow or "dense" with time and further blur the vision. Many years ago, a cataract was only removed after it became "ripe," or densely yellow. With new advances in state-of-the-art cataract surgery, cataracts are typically removed when patients develop symptoms which interfere with comfortable visual function, rather than waiting for severe visual loss. Cataracts never "grow back" once they are removed.  There are two options available: (1) a surgical incision is made with a small knife and the cataract is broken up with ultrasound or (2) a computer-guided laser system makes the bladeless incision and gently vaporizes the old, cloudy lens.  Patients may also have the option of choosing lens implants that improve distance vision, reading vision, or both.  Dr. Cohn is proud to offer specialty lens implants including the Alcon ReSTOR lens and Toric lens to help reduce presbyopia or astigmatism.  These lenses typically offer patients greater freedom from glasses.

 

THE SURGICAL PROCEDURE

b-venus cataractvenus

Botticelli's Birth of Venus

Botticelli's Birth of Venus

seen through a cataract

Prior to cataract surgery, the eye is "measured" in the ophthalmologist’s office to determine the appropriate strength of the lens implant to be used. Cataract surgery is always done as an outpatient, usually in a surgical center instead of in a hospital. Dr. Cohn, a veteran of over 10,000 eye surgeries, uses the most up-to-date surgical techniques in removing cataracts. He uses the Alcon LensX laser system to perform computer-guided bladeless incisions.  This gentle and precise technique is a true technological breakthrough, providing a safe and accurate method to remove a cataract with less energy than the older ultrasound technique.  An alternative to laser, the common technique of phacoemulsification, which uses ultrasound energy to gently break up the cloudy lens, has been successfully used by Dr. Cohn for almost two decades.  The lens implant is inserted into the eye through the tiny incision, and the implant stays there for the life of the patient. The entire procedure usually takes less than 10 minutes! The eye is completely numb during this procedure, and the patient is awake but very comfortable thanks to mild intravenous sedation. The surgical incision is so small that no stitches are usually needed! Often no patches are required, and patients leave for home less than an hour after surgery. Patients are usually comfortable, and resume normal activities very soon after surgery.

 

After the surgery

 

After cataract surgery vision may be slightly blurred for a few days. Few physical restrictions are placed on the patients. We advise patients to avoid heavy lifting, swimming, and head-jarring exercises (like aerobics) for a week. Patients may cook, go for walks, bicycle rides, and even play golf the next day. Those who work may return to work the day following surgery. Patients wear a protective shield at bedtime only for 5 days. Several different eyedrops are used after surgery. These help to prevent infection and decrease inflammation. Patients often have a significant reduction in their need for glasses after cataract surgery. Many will require only reading glasses. If cataracts are present in both eyes, the second cataract may be removed a couple of weeks after the first, depending on how the patient heals.

 

Risks of surgery

 

No surgical procedure is completely free of risk, however the risk of complications from cataract surgery is lower than when compared to most other types of surgery. The complication rate from cataract surgery is generally less than 1% and might include infection, bleeding problems, wound-healing problems, or a rare problem with the implanted lens. A surgical consent form with more information is signed by the patient prior to scheduling any procedure.

femtolaserincisions

The ultimate in precision: bladeless incisions in Dr. Cohn's laser cataract surgery