1. What is a Cataract?

A CATARACT IS A CLOUDINESS IN THE NATURAL LENS OF THE EYE
Impaired vision results from the blockage and scattering of incoming light. When routine activities like work, reading, and driving become difficult, cataract surgery is conducted. Cataracts are widespread, affecting around 60% of older adults and approximately 24 million Americans. Several factors contribute to cataract formation, including exposure to ultraviolet light, diabetes, medication use, smoking, and the natural aging process.

“Cataracts Affect 24 Million Americans!”

Healthy Eye With Clear Lens

An Eye With A Cataract Has a Cloudy Lens

Cataract Overview

2. What Symptoms Do Cataracts Cause?

CATARACTS CAUSE IMPAIRMENT OF VISION THAT IS NOT CORRECTABLE WITH EYEGLASSES.

This interferes with everyday activities such as reading, driving, and working. Impairments often manifest as blurred vision and reduced contrast. Additionally, nighttime vision is negatively affected by glare, halos, and starbursts.

CLOUDY OR BLURRY VISION

IMPAIRED NIGHT VISION OR GLARE

DOUBLE VISION IN ONE EYE

DISCOLORED VISION

FREQUENT NEED FOR NEW PRESCRIPTIONS

3. When is a cataract ready for surgery?

WHEN CONSIDERING CATARACT SURGERY, KEEP THESE QUESTIONS IN MIND:

Are you concerned about your safety while driving at night due to halos or glare?
Do you experience difficulties when reading or watching television?
Has your level of independence been affected by vision problems?
Do bright lights make it difficult to see?

“Do you feel unsafe to drive at night because of halos or glare?”

Nighttime Cataract Symptoms

4. How are cataracts diagnosed?

AN EYE EXAM AND SEVERAL DIAGNOSTIC TESTS ARE PERFORMED INCLUDING:

A VISUAL ACUITY TEST

This test measures the sharpness of your vision and determines the level of impairment.

SLIT-LAMP EXAMINATION

A slit-lamp microscope is used to examine your eyes under magnification. This allows the ophthalmologist to observe and assess the cataract in detail.

RETINAL EXAM

Advanced retinal cameras such as a Optos and OCT are employed to capture high-resolution images of the retina. These images help screen for conditions like macular degeneration, allowing for early detection and monitoring.

TOPOGRAPHY

A specialized camera, such as the Pentacam, is used to map the curvature and shape of the cornea. This provides valuable information for assessing corneal conditions and planning procedures like refractive surgery.

LENS POWER CALCULATION

The Pentacam AXL and IOL master 700 devices precisely measures the eye to determine the appropriate power of the intraocular lens (IOL) used during cataract surgery. This calculation ensures optimal vision correction after the procedure.

Macular Degeneration Screening

OPTOS RETINA CAMERA

RETINA OCT

5. Where is cataract surgery performed?

CATARACT SURGERY IS PERFORMED BY AN OPHTHALMOLOGIST AT AN AMBULATORY SURGERY CENTER (ASC).

Although the surgery itself usually lasts only 10 to 15 minutes, you should anticipate spending approximately 1-2 hours at the ASC. Once the surgery is completed, you can typically return home within 30 minutes. This outpatient method enables a faster and more convenient experience for cataract surgery patients. Dr. Anderson performs cataract surgery at Premier Surgery Center in Colorado Springs, an advanced facility certified by Medicare, ensuring a comfortable and safe environment for the procedure.

“You’ll be free to go home 30 minutes after the surgery is completed.”

Ambulatory Surgical Center

6. WHAT IS TOPICAL AND “TWILIGHT” CATARACT SURGERY ANESTHESIA?

Topical Anesthesia

CATARACT SURGERY IS PERFORMED USING TOPICAL ANESTHESIA (EYEDROPS) ALONG WITH CONSCIOUS SEDATION, COMMONLY KNOWN AS “TWILIGHT” SEDATION.

Conscious sedation involves administering a small amount of anesthesia to induce a “twilight” or drowsy state. This technique aims to enhance your comfort during cataract surgery.

7. What are the steps of cataract surgery?

THERE ARE THREE BASICS STEPS TO CATARACT SURGERY:

The first step is to make tiny, precise incisions through the cornea and into the capsule of the cataract.
In the second step, ultrasound energy is used to break up and remove the cataract.
Finally, a clear artificial lens is inserted to restore vision and focusing power.

Step 1 Incision

Step 2 Phacoemulsification

Step 3 Lens Implantation

8. What is laser cataract surgery?

LASER CATARACT SURGERY HAS BECOME AN INCREASINGLY POPULAR OPTION.

This technique enhances the precision and accuracy of cataract surgery by replacing certain manual steps with laser technology. It also aids in softening the cataract, resulting in the use of less energy during the procedure. This reduced energy usage may contribute to a faster visual recovery. It has become an increasingly popular option for cataract surgery due to its advantages over traditional manual techniques.

9. Which Method Is Best: Laser Cataract Surgery vs Traditional Surgery?

BOTH METHODS HAVE PROVEN SUCCESS RATES

Laser cataract surgery effectively reduces astigmatism, providing improved vision and potentially reducing the need for glasses. By reshaping the cornea, laser technology corrects the uneven focus of light caused by astigmatism, leading to clearer vision and greater independence from glasses.

INDEPENDENCE FROM GLASSES

10. What cataract lenses are available?

AN INTRAOCULAR LENS (IOL) IS AN ARTIFICIAL LENS THAT REPLACES THE CATARACT TO RESTORE FOCUS AND VISION.

Different types of IOLs are available, and the choice depends on post-surgery goals. To assist patients in making an informed decision, Dr. Anderson will offer valuable insights and recommendations to help ensure the best possible outcome for each patient’s vision restoration.

Intraocular Lenses

For individuals who want improved vision but don't mind wearing glasses, basic cataract surgery with a monofocal IOL is recommended. These "single vision" implants provide excellent distance vision, but glasses may still be needed for optimal vision, especially for near tasks.

The Symfony, Odyssey, Vivity, and Panoptix lenses provide a complete field of vision and are categorized as extended depth of focus (EDOF) or trifocal intraocular lenses. These lenses go beyond the capabilities of traditional monofocal lenses by broadening the range of focus available.

Lens Types

MONOFOCAL

The purpose of this lens is to provide patients with clear vision at a specific distance. While it effectively corrects distant vision, it typically requires the use of glasses for near vision.

MONOFOCAL TORIC

The monofocal toric lens corrects astigmatism to provides sharp vision at one distance without eyeglasses. Glasses for reading are still needed.

JNJ EYHANCE AND ENVISTA ASPIRE IOL

This next generation monofocal lens has a tiny central power change to provide more depth of field. Patients report improved intermediate vision. However, a small portion of patients may notice a decrease in distance clarity.

SYMFONY AND ODYSSEY

Tecnis Symfony OptiBlue and Odyssey are Extended Depth of Focus (EDOF) lenses that offers a complete range of vision, spanning from distance to intermediate distances. However, reading glasses are still required for small print. The Symfony OptiBlue aims to reduce the occurrence of halos and spider webbing during nighttime. This is achieved through a specialized filter that blocks the shortest wavelengths of light known for causing significant light scatter.

VIVITY

Vivity is an Extended Depth of Focus (EDOF) lens that offers a continuous range of vision. In comparison to Symfony, some patients have reported enhanced near vision, although it may come at the cost of slightly reduced distance clarity.

Panoptix Trifocal

The design of this lens enables clear vision at different distances, including far, near, and intermediate. As a result, there is a significant reduction or complete elimination of the need for glasses when reading or engaging in other activities. It offers greater independence from reliance on glasses. However, it’s important to note that this lens may occasionally cause halos when driving in the evening and decrease in distance contract or clarity.

Custom Match

An appealing option is to implant a single vision lens in one eye and a full vision lens in the non-dominant eye, thereby achieving optimal clarity for distant objects while retaining the ability to focus near. Additionally, this approach helps reduce the appearance of halos during nighttime.

Lens Option: Monofocal or Single Vision

Before Cataract Surgery

After Cataract Surgery Using Traditional Monofocal Lens

After cataract surgery with a TRADITIONAL MONOFOCAL LENS, things far away will be in focus and clear. However close up items like a computer, book, or iPhone will still be blurry without reading glasses.

11. What if I Don’t Want to Wear Eyeglasses?

IF IT IS IMPORTANT FOR YOU TO SEE WITHOUT GLASSES AFTER SURGERY, THIS CAN BE ACCOMPLISHED THROUGH LASER CATARACT SURGERY WITH A TORIC OR A FULL VISION LENS (SYMFONY, VIVITY, PANOPTIX).

This surgery allows ophthalmologists to go above and beyond what Medicare and private insurers cover and, as such, the implants and techniques used are not covered by insurance. In cases where astigmatism is detected, a specialized lens known as a toric IOL can be utilized. By using a toric lens, patients can achieve excellent distance vision without relying on eyeglasses, although reading glasses may still be required. For a comprehensive overview of available lens options, you can visit the Johnson & Johnson Vision Simulator.

Understanding your cataract lenses
	Near	Intermediate	Distance	Astigmatism
Monofocal [Single Vision]		++	+++++
Clear vision at one focal point — usually distance
Need glasses for near vision
Does not correct astigmatism
Toric		++	+++++	✔
Optimizes vision in the distance
Need glasses for near vision
Corrects astigmatism
Symfony/Vivity/Odyssey	++	++++	+++++	✔
Provides clear vision from intermediate to distance
Reduced need for glasses
Symfony Toric Model Corrects Astigmatism
Panoptix	++++	+++++	++++	✔
Max range of vision
Reduced need for glasses
Panoptix Toric Model Corrects Astigmatism

After Cataract Surgery Using Traditional Monofocal Lens

After Cataract Surgery Using Advanced Full Vision Lens

Cataract surgery with an ADVANCED FULL VISION LENS results in clear vision at distance, intermediate, and near without glasses.

Full Vision Lenses (Symfony, Odyssey, Vivity, Panoptix) Can Cause Halos at Night

Although certain lenses offer a complete range of vision, some patients may experience halos during nighttime. However, the majority of patients find these halos to be manageable and notice improvement as time goes on. Below, you will find sample photographs taken at night for reference.

12. What is the New Envista Aspire Lens?

The Envista Aspire Lens is an Intermediate Optimize (IO) lens that demonstrates a broader depth of focus compared to standard monofocal IOLs. The aspire lens is still considered a monofocal so readers will be needed for fine near vision.

13. What is the New Symfony Optiblue Lens?

The Symfony Optiblue Lens stands out as a recent addition among available lenses. In contrast to “single vision” lenses, this particular lens is crafted to enhance patients’ visual acuity across various distances. It offers exceptional visual clarity from far distances to approximately arm’s length, reducing reliance on eyeglasses. Wearing the Symfony lens is akin to using a +1.0 D reading glass, providing excellent distance vision alongside commendable intermediate performance.

1. Tiny circular grooves extend the range of vision

2. Haptics hold the lens in place

Minimizes the use of eyeglasses

14. What are the reviews of the Symfony Lens?

THE SYMFONY OPTIBLUE LENS HAS RECEIVED POSITIVE REVIEWS FOR A FULL RANGE OF CLEAR VISION.

While glasses might still be necessary for extended reading sessions, approximately 85% of the day can be enjoyed without them. This includes activities like using a cell phone, working on a computer, viewing photos, reading magazines, or perusing menus. It’s worth noting that the Symfony lens, depending on the size of the pupil, may lead to slightly increased halos during nighttime (8% compared to 2% with a standard lens). However, these halos tend to become less noticeable as time goes on.

85% REPORT “LITTLE TO NO” USE OF GLASSES

15. What is Presbyopia and Monovision?

Monovision is a technique to correct presbyopia, which affects near vision due to age. One eye is corrected for distance vision while the other is corrected for near vision. The dominant eye is corrected for distance, and the non-dominant eye is intentionally left slightly nearsighted. This allows the brain to rely on the dominant eye for distance and the non-dominant eye for close-up tasks. Monovision can provide good vision for both distance and near without the need for reading glasses, but it may affect clarity and depth perception for certain activities.

With newer lenses such as Envista Aspire, the near aim can be set to -1. This helps minimize side effects associated with monovision.

16. What eye drops do I need?

THE STANDARD DROP REGIMEN FOR CATARACT SURGERY IS TO USE TWO DROPS ONCE DAILY FOR 30 DAYS.

Dr. Anderson uses Bromsite and Durezol once daily for 30 days along with a steroid and antibiotic placed inside the eye at the end of surgery to minimize the risk of infection.

17. What Does Cataract Surgery Cost? Does Medicare Cover Cataract Surgery?

CATARACT SURGERY IS A MEDICALLY NECESSARY PROCEDURE AND COVERED BY MOST HEALTH INSURANCES.

Costs of the patient can vary, depending on your responsibility for your copay and your annual deductible. Medicare, for example, pays 80% of the cost of cataract surgery after you have met your deductible. If you have a Medicare supplemental plan, then they generally cover the other 20%. Dr. Anderson also offers self-pay cataract surgery starting at $3,000-$5,500 per eye

18. What are the risks and complications of Cataract Surgery?

ADVANCEMENTS IN TECHNOLOGY AND SURGICAL TECHNIQUES HAVE MADE CATARACT SURGERY A COMMON AND SAFE PROCEDURE.

According to the American Society of Cataract and Refractive Surgery (ASCRS), 4.5 million cataract surgeries are performed annually, with an overall success rate of 98 percent. With any surgery, there is a small risk of potential complications including retinal detachment and infection. Dr. Anderson minimizes the risk of retinal detachment by combining a careful dilated eye exam with an Optos Wide Field Retina Camera. The risk of infection is minimized by placing antibiotics inside the eye at the end of surgery.

19. Can Cataract Surgery Prolong Your Life?

A RECENT STUDY SHOWED A 60% LOWER RISK OF DEATH.

According to a large 20 year study of 74,000 women aged 65 and older, there was a 60 percent lower risk of death among the 42,000 women who had their cataracts removed. A New York Times article highlighted that when people can see better, “they can also move more and get more exercise. They can see their pills better and may be more likely to take them and take the right ones. The surgery also improves visual contrast, which decreases the risk of accidental deaths from falls or driving.”

20. What is Posterior Capsule Opacification [PCO]?

A PCO IS A THICKENING OF THE LENS CAPSULE.

This occurs after cataract surgery and causes hazy vision. It is fairly common but easily treatable with a YAG laser. This procedure is painless with a fast recovery.

“This procedure is painless with a fast recovery.”

PCO

21. What is the preoperative preparation for cataract surgery?

PLEASE AVOID ANY FOOD OR LIQUID FOR 12 HOURS PRIOR TO SURGERY.

To prepare for surgery, make arrangements for a ride to and from the surgery center. On the day of surgery, avoid any food or liquid for 12 hours prior to cataract surgery. If you are on a blood pressure or heart medicine, please take these with a sip of water. The entire cataract surgery will take about 2-3 hours. Wear comfortable clothes, and avoid wearing eye make-up on the day of surgery.

DON’T EAT FOR 8 HOURS BEFORE SURGERY

22. What the post-operative instructions after cataract surgery?

Here are a few instructions to follow after cataract surgery:

Avoid touching or rubbing the eye. A clear shield will be used to prevent any unintentional eye rubbing when sleeping.
Be active around the house but do not do anything more strenuous. Avoid lifting anything in excess of 25 pounds as it can increase pressure in the eye. You can gradually increase to normal activities by the end of the first week.
You may perform light exercise (treadmill, etc.) beginning 3-4 days after surgery. You may golf and play tennis after one week. Swimming should be avoided for two weeks.
You may carefully bath but try not to get a stream of water directly into the eyes.
ONLINE INSTRUCTIONS: Click here for further cataract surgery instructions

23. What’s the recovery time and time off work after cataract surgery?

CATARACT SURGERY HAS A QUICK RECOVERY TIME.

Most people are back to light activities within 2-3 days and return to work within 1 week.

“Most people are back to work within a week.”

24. Where can I learn more about cataract lenses?

Thanks to recent advancements in cataract lenses, you have the opportunity to select the lens that will be implanted. To assist you in making an informed decision, Johnson & Johnson Vision has created a simulator that provides comprehensive information on the vision changes caused by cataracts as well as the available lens options. While the simulator can be helpful in making a lens choice, it is crucial to have a detailed discussion with your ophthalmologist about your specific goals for cataract surgery..

Cataract Simulator

Do you need Cataract Surgery? Schedule an evaluation with Dr. Anderson.

It’s important for individuals with cataracts to consult with an eye care professional to discuss their specific situation and explore the available treatment options. Dr. Anderson’s expertise in advanced cataract care and the comprehensive services provided can greatly benefit those seeking effective treatment for cataracts.