The technique of cataract removal has undergone major changes and improvements. Not too long ago, cataracts were removed as one big piece through an incision over ½ an inch long. Today, our surgeons perform cataract surgery through an incision just slightly longer than 1/16 of an inch. A hand held surgical instrument is inserted through this 1/16-inch incision; ultrasound breaks (emulsifies) the cataract into many tiny pieces, which eliminates the need for a larger incision. There are many advantages to this smaller incision, a faster recovery time, decreased need for glasses after surgery, and a reduced risk for infection after surgery. In addition, many stitches were required to close up the old ½ inch incision. When our surgeons perform cataract surgery no stitches are usually needed, or at most 1 stitch.

During modern cataract surgery, the cloudy lens of the eye is removed and replaced with a clear lens implant. In the old days, there were no lens implants, and patients had to wear thick glasses after surgery. Now there are implant lenses that are inserted directly into the eye, reducing the need for glasses after surgery. The newest technology in implant lenses can even provide sharp vision at both distance and near, reducing or eliminating the need for glasses (even reading glasses) after surgery. Prior to surgery our surgeons help patients determine which type of implant lens is best for them.

Another dramatic advance in cataract surgery involves anesthesia. Long ago, patients were put to sleep with a general anesthetic. More recently, patients were given a shot behind the eye before surgery to numb the eye. Our surgeons perform the majority of adult cataract surgeries under topical anesthesia. Topical anesthesia requires numbing drops be instilled on the eye prior to the start of surgery, and it eliminates both the risks and discomfort of the shot behind the eye. Additionally, the shot made the patients vision blurry for several hours after surgery. With just numbing drops, patients notice more rapid improvement of vision.

Advancements in antibiotics have also benefited patients undergoing cataract surgery. Cataract surgery is among the most successful operations in all of medicine, but complications can occasionally occur. One of the most severe complications is an infection in the eye called endophthalmitis. To reduce the chances of getting endophthalmitis, our surgeons will prescribe antibiotic eye drops to be used before and after surgery. Additionally, good hand washing technique is critical prior to instilling any eye drops. The development of new antibiotics in the past few years have helped in reducing eye infections during cataract surgery.

Cataract surgery is so well tolerated that it has become the most common surgery performed on adults in the United States. The high tech developments discussed above have helped make cataract surgery more successful than ever before.

Implant Lens Choices with Cataract Surgery
The lens of your eye is an important structure. In order to see clearly at all distances (up close to far away), your eye must be able to change its focus. The lens of your eye is responsible for this change in focus – it changes its shape to bring whatever you're looking at into clear focus. In your early 40s most individuals loose their ability to see up close, and require either bifocals or reading glasses. As we age, the lens of the eye hardens and cannot change its shape.

When the lens of the eye becomes cloudy it is called a cataract. Cataracts are a common problem among aging Americans, and cataract surgery is the most common surgery performed on adults in the Untied States. In cataract surgery, the cloudy lens is removed. In order for you to see clearly after surgery, an artificial lens (called an intraocular lens implant, or IOL) needs to be inserted at the time of surgery.

Selecting the right implant for your eye is very important. Our specially trained technicians will use a highly technical instrument used to measure the length (front to back) of your eye. Combined with additional ocular measurements the results are analyzed by a sophisticated computer program. Our doctors use these results to select the most appropriate power of intraocular lens for your eye.

Our doctors will discuss the options for your vision after surgery. Several options are available to help minimize the need for any type of glasses after cataract surgery. One option is to place implants in your eyes with a strength that will allow you to see well at distance, and wear reading glasses when you want to see up close for reading. Another option is to select an implant strength for you to see clearly at a distance for one eye, and a different strength for the other eye so you can see clearly to read. This is called monovision.

In recent years, multifocal implants have been developed. These lenses allow you to clearly at a variety of distances. Multifocal lens technology is evolving rapidly and patients are encouraged to consult with their doctor about these offerings. The multifocal lenses are new technology are relatively expensive and are not covered by Medicare or other secondary payors. Because of this, the patient must pay the difference in price between a standard implant and the multifocal implant.

Talk with your doctor about the various types of implants available, and their effects on your vision after surgery. You and your doctor will develop a plan that will give you the best type of implants for your eye and your vision needs.

Before Cataract Surgery
Once the diagnosis of cataracts has been made, and the decision has been made to have your cataract removed, you will go through several steps to prepare you for surgery. Our doctors and staff place great emphasis on helping you to understand the planned surgical procedure and how it is intended to benefit you. We will prepare you for the procedure as well as for the post-operative recovery period. Our surgery counselor will discuss your preoperative instructions, a bag with dark glasses will be given to you as well as prescriptions for eye drops.

Special measurements will be taken of your eyes. These measurements help our doctors select the power of the intraocular implant lens that will best serve your lifestyle and vision needs. Many patients enjoy a decreased dependency on glasses after surgery.

After Cataract Surgery
You will feel good after your surgery, but remember you cannot drive yourself home, so make sure to arrange for a ride home. It is normal to feel itching and even slight discomfort for a few days following your surgery. You will use eye drops as directed that will help will these symptoms.