A view toward advances in cataracts surgery

There is an old expression that nothing is certain but death and taxes. If you live long enough, you can add cataracts to the list. Cataracts affect more than half of Americans by age 80, according to a report from the National Eye Institute and Prevent Blindness America.A cataract is caused by a build-up of protein in the lens of the eye. In a healthy eye, the lens transmits the light rays that pass through the eye to the retina, which sends a visual image to the optic nerve and ultimately to the brain. When protein builds up, it clouds the lens and prevents light from passing clearly through it.

Once the cataract becomes dense enough to interfere with the light rays passing through the lens, symptoms can include blurriness, glare and changes with color perception or night vision. These impairments can curtail not only recreational pursuits, but also basic activities like reading or driving a car.

Fortunately, surgery can replace the cloudy lens with an intraocular implant and restore normal vision. In recent years, significant advancements in the precision and safety of this procedure have resulted in shorter surgery and recovery times and greatly improved results. Over the years, the incisions required for surgery have become increasingly smaller. Today the incisions are so small that no sutures are needed — the micro-incisions heal by themselves, and patients can return to usual activities almost immediately.

Just a few years ago, a monofocal implant was the only choice for cataract surgery patients. As its name implies, the monofocal implant focused light only at a single distance, either near or far. Patients who chose distance vision would still need eyeglasses for near vision, and vice versa. Now, with the recent advent of a multifocal lens implant that enables the eye to have both distance and near vision, patients are seeing better than they have in decades without the need for glasses. These high technology lens implants allow patients to see near, far and everything in between uncorrected.

 

Until recently, implants could not correct astigmatism, a condition that causes blurred vision due to an irregularly shaped cornea. New toric implants can neutralize the misshaped corneas that patients have lived with all of their lives, allowing them to reduce their reliance on distance glasses. Dime store reading glasses might still be required for close work.

 

In the near future, the dream of laser cataract surgery may become reality. The FDA has just approved Femtosecond laser technology for use in cataract surgery. Femtosecond lasers have been utilized for the past several years in the Lasik procedure to create a blade-free flap. These lasers will allow the cataract surgeon to perform blade-free, customized, reproducible incisions that will predictably eliminate astigmatism. This technology uses 3-D computer imaging to guide the laser into the eye, where it can perform custom lens fragmentation, which softens the cataract allowing for easy removal. The surgeon then completes the procedure by placing the new lens implant into position.

 

“Health Watch” is brought to you by the physicians and staff at Scripps Memorial Hospital Encinitas. For more information or for physician referral, call 1-800-SCRIPPS or visit www.scripps.org.

 

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