1. What is a Cataract?

A CATARACT IS A CLOUDINESS OR OPACITY IN THE NATURAL LENS OF THE EYE THAT SITS BEHIND THE IRIS.
It impairs vision by blocking and scattering incoming light. Cataract surgery is performed when normal activities [working, reading, and driving] become difficult. Cataract development is very common and occurs in 60% of older adults and affects 24 million Americans. There are multiple factors associated with cataract development including ultraviolet light exposure, diabetes, drug use, smoking, and unfortunately the natural process of aging.

“Cataracts Affect 24 Million Americans!”colorado-springs-map

Colorado-springs-cataract-surgery
Healthy Eye With Clear Lens
Cataract-Surgeon-Colorado-Springs
An Eye With A Cataract Has a Cloudy Lens

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, watching television, driving, and working. Impairments are commonly caused by blurred vision and loss of contrast. Nighttime vision is decreased by glare, halos, and starbursts. If you are having only difficulty with reading you may have Dysfunctional Lens Syndrome and may benefit from a Dysfunctional Lens Replacement Surgery. Learn more here about DLS.

Cataract-Symptoms
Cloudy or Blurry Vision
cataract-symptoms-discolored-vision
Discolored Vision
cataract-symptom-impaired-night-vision
Impaired Night Vision or Glare
cataract-symptom-frequent-need-for-new-prescriptions
Frequent Need for New Prescriptions
double-vision
Double Vision in One Eye

3. When is a cataract ready for surgery?

WHEN CONSIDERING CATARACT SURGERY, KEEP THESE QUESTIONS IN MIND: 

  • Do you feel unsafe to drive at night because of halos or glare?
  • Do you have problems reading or watching television?
  • Is it difficult to cook, shop, climb stairs or take medications?
  • Do vision problems affect your level of independence?
  • Do bright lights make it difficult to see?

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

Nighttime Cataract Symptoms

Cataract-Surgery-Indications

4. How are cataracts diagnosed?

AN EYE EXAM AND SEVERAL DIAGNOSTIC TESTS ARE PERFORMED INCLUDING:

  • A visual acuity test: Detects level of vision impairment.
  • Slit-lamp examination: Allows the cataract to be seen under magnification.
  • Retinal exam: Two advanced retinal cameras [Optos and OCT] screen for macular degeneration
  • Topography: A special camera [Pentacam]  maps the surface of the eye [cornea].
  • Lens Power Calculation: An IOLMaster precisely measures the length of the eye.

Macular Degeneration Screening

evaluation-testing

5. Where is cataract surgery performed?

CATARACT SURGERY IS PERFORMED BY AN OPHTHALMOLOGIST AT AN OUTPATIENT AMBULATORY SURGERY CENTER [ASC]. 

This means you don’t have to stay in the hospital. The cataract surgery takes about 15 minutes. You’ll be free to go home 30 minutes after the surgery is completed. 

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

Ambulatory Surgical Center

Ambulatory-Surgery-Center-ASC

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

Topical Anesthesia

Eye-Drops-After-Cataract-Surgery

CATARACT SURGERY IS DONE USING A TOPICAL ANESTHETIC [EYEDROPS] COMBINED WITH “TWILIGHT” OR CONSCIOUS SEDATION.

Conscious sedation is a technique where a small dose of anesthesia is given to induce a “twilight” or sleepy state.  Twilight anesthesia is designed to make you feel more comfortable during cataract surgery.

7. What are the steps of cataract surgery?

Cataract-Surgery-Steps
Step 1 Incision
Cataract-Surgery-Steps
Step 2 Phacoemulsification
Cataract-Surgery-Steps
Step 3 Lens Implantation

THERE ARE THREE BASICS STEPS TO CATARACT SURGERY:

  1. The first step is to make tiny, precise incisions through the cornea and into the capsule of the cataract.
  2. In the second step, ultrasound energy [“phaco”] is used to break up and remove the cataract.
  3. Finally, a clear artificial lens [intraocular lens or IOL] is inserted to restore vision and focusing power.

8. What is laser cataract surgery?

Colorado Springs Laser Cataract Surgery

LASER CATARACT SURGERY HAS BEEN USED TO REMOVE CATARACTS FOR THE PAST DECADE.

It makes cataract surgery more precise and accurate by replacing the need for hand-held instruments for certain steps. It also softens the cataract, so less energy is used. Using less energy may lead to a quicker visual recovery but overall the outcomes are similar.

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

BOTH METHODS HAVE PROVEN SUCCESS RATES 

If independence from glasses is desired, laser cataract surgery can be used to reduce the amount of astigmatism. Astigmatism is a refractive error where the eye does not focus light evenly on the cornea.

Independence From Glasses

cataract-surgery-no-more-glasses

10. What cataract lenses are available?

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

There are three different IOLs to use, and the right one depends on post-surgery goals. If the desire is to simply see better, and you don’t mind wearing glasses, then Basic Cataract Surgery is recommended. The “single vision” or monofocal implants used in basic surgery are superb but eyeglasses may be needed to achieve optimal vision. Single vision lenses focus the vision usually for the distance and then readers are needed for near vision.

Standard Monofocal Lens

Lens-Options

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 CUSTOM CATARACT SURGERY.

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. If astigmatism is present a special lens called a toric IOL can be used. A toric lens will provide the best distance vision without the use of eyeglasses but readers may be needed. Visit the Johnson & Johnson Vision Simulator to Explore All the Lens Options. A link is provided at the bottom of this page.

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 ++ ++++ +++++
Clear vision over a range of distances
Reduced need for glasses
Symfony Toric Model Corrects Astigmatism

12. What is the New Symfony Lens?

The Symfony Extended-Range Intraocular Lens [Johnson & Johnson Vision] is the newest lens and unlike “single vision” lenses, the Symfony is designed to help patients see over a range of distances. It provides high quality vision from the far distance to about arm’s length to minimize the use of eyeglasses. To keep it simple, the Symfony Lens is like wearing a +1.5 D reading glass. This gives good intermediate performance while maintaining excellent distance vision.

Cross-section

Lens-Options-Symfony-Multifocal

1. Tiny circular grooves extend the range of vision

2. Haptics, or side struts, hold the lens in place


“Minimizes the use of eyeglasses.”

13. What are the reviews of the Symfony Lens?

THE SYMFONY LENS HAS RECEIVED POSITIVE REVIEWS DUE TO ITS RANGE OF CLEAR VISION.

Although glasses may still be needed for prolonged reading; 85% of the day will be glasses free such as when using a cell phone, computer, looking at photos, reading magazines or menus. Depending on pupil size, the Symfony lens can cause slightly more halos at night (8% vs 2% for a standard lens). These halos become less noticeable over time.

85% REPORT “LITTLE TO NO” USE OF GLASSES

eyeglasses-after-cataract-surgery

14. What eye drops do I need?

THE STANDARD DROP REGIMEN FOR CATARACT SURGERY IS TO USE TWO TO THREE DROPS SEVERAL TIMES DAILY.

This works well but it is now possible to use only ONE drop ONCE per day [Bromsite] when used in conjunction with a medicine placed inside the eye at the end of surgery [Tri-Moxi].

“Only ONE drop ONCE per day for three weeks.”

Bromsite Eye Drop

Cataract-Drops-after-Surgery

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

CATARACT SURGERY IS A MEDICALLY NECESSARY PROCEDURE AND COVERED BY MOST HEALTH INSURANCES EVEN IF YOU DON’T HAVE “VISION INSURANCE”.

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 [cash] cataract surgery starting at $2500-$3000 per eye. 

Cash Pay Cataract Surgery Cost 2017

What-Does-Cataract-Surgery-Cost-in-Colorado-Springs

16. 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), 3 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. 

 Cataract-Surgery-Complications

17. 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.”

New-York-Times-Article

18. 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 in the office with a laser. This procedure is painless with a fast recovery.

“This procedure is painless with a fast recovery.”

PCO

Secondary-Cataract-PCO-posterior-Capsule-Opacification

19. What is the preoperative preparation for cataract surgery?

PLEASE AVOID ANY FOOD OR LIQUID FOR 6 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 6 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 3 hours. Wear comfortable clothes, and avoid wearing eye make-up on the day of surgery.

Don't Eat For 6 Hours Before Surgery

preoperative-preparation-for-cataract-surgery

20. 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 15 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 bathe but try not to get a stream of water directly into the eyes.
  • Print Instructions: Click here for a printable copy of post-operative cataract surgery instructions
  • ONLINE INSTRUCTIONS: Click here for further cataract surgery instructions
after-surgery-instructions

21. 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.”back-to-work

Cataract-Surgery-recovery

22. Where can I learn more about cataract lenses?

With today’s advancements in cataract lenses, you now have a choice in what lens is implanted. To help in the decision process, Johnson & Johnson Vision has developed a simulator that details the vision changes that can occur from a cataract and all of the available lenses. This simulator can help in making a lens decision but a detailed discussion with your ophthalmologist about your cataract surgery goals is most important.

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

Contact Us

Erik Anderson MD

eye-doctor-light-logo