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Cataract Surgery Options – Austin Eye

The Cataract Surgery Decision:

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WHAT IS A CATARACT?

The eye focuses images through a lens inside the eye — like a camera uses a lens to focus. When we are born, the lens is clear and flexible, allowing crisp vision with a full range of focus from near to far. As we age, the lens becomes cloudy and inflexible, causing our vision to blur and increasing our dependence on glasses to refocus from far to near.

 

 

 

A cloudy lens is called a cataract. Because of the clouded lens or cataract, images may become blurry with age. Cataracts may make it progressively more difficult to read, drive, watch TV, and perform normal daily activities, and may blur vision in general. Cataract formation is a normal, unavoidable part of the aging process.

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HOW DO I KNOW IF I HAVE A CATARACT?

If you are over the age of 50, you have and are developing cataracts as a normal part of the aging process. Though uncommon, some individuals develop cataracts as children or young adults.

Common symptoms of cataracts include:

  1. Blurry vision
  2. Difficulty seeing while driving at night
  3. Inability to see the TV clearly
  4. Difficulty reading or discerning fine details
  5. Glare around lights at night
  6. Cloudy, foggy, fuzzy, filmy vision
  7. Problems seeing colors clearly
  8. Loss of vision in low-contrast situations such as early morning or evening
  9. Light sensitivity
  10. Double vision

In order to determine if you have a cataract and if it is visually significant, an eye examination by an ophthalmologist is necessary. If the cataract is mild then surgery is not needed. Quite often an updated pair of eyeglasses will help optimize your vision. However, if your vision remains blurred in spite of wearing properly prescribed glasses then the next step will be to consider cataract surgery.

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Once you know that you have a cataract then you can choose one of two options:

1) Leave the cataract alone and continue to wait until your vision worsens OR have cataract surgery to improve your vision.

Cataracts are not like having life-threatening heart disease or cancer. Time is on your side. You can wait and leave your cataract alone. As long as you are not unhappy with your vision, leaving the cataract alone is acceptable and safe. If you choose to defer cataract surgery, your vision will remained blurred and the blur will only worsen as time passes. When your level of frustration with your blurred vision is no longer acceptable, then you can choose to have cataract surgery.

2) If you choose to improve your vision through cataract surgery, you have a choice of what type of cataract surgery you will receive. Your choice will determine how dependent you are on glasses and/or how well you can see without glasses after your surgery.

There are three options:
1) Basic cataract surgery with a basic fixed-focus lens implant to see clearly with bifocal glasses.
2) Laser cataract surgery with the astigmatism correction package to see clearly far away without glasses OR
3) Laser cataract surgery — premium package — with an advanced technology lens designed to see clearly near and far without glasses.

For Austin bladeless laser cataract surgery patients, we use a variety of lens implants that correct astigmatism and enable individuals to focus on far and near objects without relying on glasses in most instances.

In general, there are three “zones of vision” that we use to see the world around us:

  • Near (reading print on a piece of paper)
  • Mid-range (computer distance)
  • Far (TV and street signs while driving)

seniors-cardsTo summarize, when you have a cataract you have options. Our physicians and staff will help guide you to the option that works best to suit your lifestyle.

Basic cataract surgery with a basic fixed-focus lens gives good vision at one of three zones. During basic cataract surgery your doctor uses hand-held instruments and blades to remove your cataract, and in its place a basic fixed-focus lens implant is used to correct your vision. With basic cataract surgery, you will see clearest far away, but less clear at mid-range and blurry for near. Basic lens implants do not correct astigmatism. If a patient has astigmatism, which means that the front part of the eye is shaped more like the back of a spoon rather than round like a ping pong ball, then the patient would most likely end up in bifocals after surgery for best corrected vision. Individuals with basic cataract surgery usually see fairly well far away without glasses. In order for your eye to see all three zones, you will need glasses. Individuals receiving basic cataract surgery have a 90-95 percent chance of still needing to wear glasses to read or bifocals to see their best. Approximately 5 percent of our basic cataract surgery patients are glasses-free for all three zones of vision after cataract surgery to both eyes. If you have a visually significant cataract as determined by your eye exam with your ophthalmologist and you have medical insurance, then basic cataract surgery is typically covered by your medical insurance. You would just pay your copayment or deductible.

In addition to performing basic cataract surgery, Dr. Mitchel Wong, Dr. Shannon Wong, and Dr. John Odette were the first surgeons to perform laser cataract surgery here in Austin. This is the most advanced technology that exists for cataract surgery today. Our surgeons have the most experience performing laser cataract surgery in Austin. The initial steps of laser cataract surgery are done with a precise computer-controlled laser rather than hand-held surgical tools and blades. Laser cataract surgery is more precise than manual basic cataract surgery and is paired with astigmatism correction and/or a premium adjustable-focus lens.

Laser Cataract Surgery with the Astigmatism-Correction Package
Austin Eye also offers this type of laser cataract surgery for patients that have large amounts of astigmatism who want to see clearly far away without glasses but don’t mind using glasses to enable them to see up close. In this type of cataract surgery, the initial steps of the procedure are done with the laser just like described above, but we pair this procedure with surgery to reduce or eliminate your astigmatism by either reshaping the cornea with the laser or using an astigmatism-correcting lens implant or both. With the eye set to see normally far away and the astigmatism corrected most patients see very clearly far away without glasses but need reading glasses to see clearly up close. This type of surgery is also available to those who really want to have laser cataract surgery, but do not wish to have an adjustable-focus lens. Astigmatism-correcting lenses reduce or eliminate astigmatic focusing issues in addition to correcting your far away vision. Most individuals with an astigmatism reducing lens will see quite well without glasses far away. Most astigmatism-correcting lens implants do not allow an adjustable range of focus. Therefore, though your vision will be clear far away without glasses, you would require glasses to see up close (near) and at the computer (mid-range) after cataract surgery. If you have a visually significant cataract as determined by your eye exam with your ophthalmologist and you have medical insurance, then your cost for the laser cataract surgery astigmatism-correcting package is $2,600/eye in addition to your co-payment or deductible.

Laser Cataract Surgery Premium Package
Laser premium cataract surgery is laser cataract surgery designed to enable you to see both far and near with minimal or no dependence on glasses. Laser premium cataract surgery involves astigmatism correction as well as the use of advanced-technology lens implants designed to provide clear vision over a broader range of distances than basic lens implants. They will provide at least two zones of clear focus. The Crystalens, for example, provides excellent vision far and mid-range for driving, watching TV and working at the computer, but you may need to wear over-the-counter reading glasses for fine print up close. Multifocal lenses such as the Tecnis multifocal or the ReSTOR lens will provide excellent vision far and near for driving, watching TV or reading small print up close, but you may need to wear over-the-counter reading glasses to see computer distance optimally. The Symfony Extended Depth of Focus lens is the most advanced lens implant to date to allow seamless vision from near to far.

If you have a visually significant cataract as determined by your eye exam with your ophthalmologist and you have medical insurance, then laser cataract surgery with an advanced technology lens has an out-of-pocket cost of $4,000/eye in addition to your copayment or deductible.

 

WHAT HAPPENS DURING MY CONSULTATION?

During your consultation, we will do advanced diagnostic tests to determine which cataract surgery option would best suit your needs. There are varying reasons that determine the type of procedure we offer a patient. Since everyone’s eyes and visual needs are different, your surgeon will evaluate your eyes and inform you what your best option is. When a patient is interested in laser cataract surgery, we perform more extensive testing to make sure the patient is a good candidate. One of the tests that we perform takes a high-definition picture of the back part of the patient’s eye known as the macula. The doctor will evaluate the health of the patient’s eye to see if a premium lens will be of benefit to the patient. We also perform a test known as cornea topography, which takes a topographical map of the cornea (front window of the eye) and maps out and quantifies your astigmatism. These tests allow the surgeon to see exactly which procedure will best benefit your eyes. The surgeon will also perform an additional advanced diagnostic test during surgery known as ORA Optiplus Refractive Analysis to pick the exact power of the lens implant that will be placed in your eye.

 

PAYING FOR CATARACT SURGERY

Austin Eye offers a convenient monthly payment plan through a company known as CareCredit. CareCredit is like a medical credit card which can be used to pay for your surgery. You can pay for your surgery over a 24-month period in convenient monthly payments without interest on the amount you finance. CareCredit can be used for any type of procedure you decide to have done, and it is a convenient way to make elective surgery more affordable for you. When you come in for your consultation, we can contact your insurance provider to obtain an estimate of costs for your surgery.

To summarize, when you have a cataract you have options. Our physicians and staff will help guide you to the option that works best to suit your lifestyle. Fortunately, cataract surgery is now a quick, painless, safe outpatient procedure done routinely by Dr. Mitchel Wong, Dr. Shannon Wong and Dr. John Odette. Cataract surgery is performed weekly on Mondays, Tuesdays and Wednesdays by our team of ophthalmologists.

 

WHAT HAPPENS DURING CATARACT SURGERY?

Cataract surgery is one of the most common surgical procedures performed in the United States. Our Austin surgeons have performed tens of thousands of cataract surgeries and are among the most experienced in the country. Your cataract surgery is a convenient outpatient procedure. We will numb your eyes with anesthetic eye drops. We will give you a valium tablet prior to surgery to ease your nerves and help you stay relaxed and calm during your procedure. You will need someone to drive you home after surgery. We do one eye at a time, and typically wait one week in between surgeries just to make sure you are happy and healing well. The day of your surgery, plan to be at the office for about two hours (this is an estimate), but the procedure itself only takes about 20 minutes. Most patients go home and take a nap after surgery, and will be seeing better within six hours. The restrictions after surgery are very minimal, and you can resume all of your normal activities the very next day so long as you feel comfortable. We just ask that you avoid rubbing your eyes, doing any heavy lifting (any exertion that would cause you to squeeze your eyelids forcefully), and swimming for one week. We ask that no eyelid makeup be applied around the eyelids or on the lashes for one week after surgery.

At Austin Eye, we realize that having your vision restored through lens replacement is a life-changing decision that will improve your quality of life. We appreciate the trust you have placed in us in choosing our practice and surgeons to correct your vision.

 

WHAT IS THE “RIGHT TIME” TO HAVE CATARACT SURGERY?

Cataract surgery is indicated when one’s vision is sufficiently blurry to impair one’s ability to see comfortably while performing their usual activities. Usually your ophthalmologist will try to prescribe glasses to optimize vision before proceeding with cataract surgery. The timing of cataract surgery is dependent on your decision to proceed with surgery… there is no magic time by which a cataract must be removed from the eye. In fact, if a patient is happy with his or her blurred vision, the cataract can be left alone. As the person ages, the cataract will generally progress and the lens will become cloudier, further impairing vision.

Patients who choose cataract surgery do so because of one of two reasons: 1) Intolerance of the blur that the cataract creates (e.g., difficulty driving, reading, seeing the world clearly, watching TV) or 2) The desire to improve overall vision and reduce or possibly eliminate dependence on glasses. In essence, the ability to see younger without glasses is often a powerful incentive to pursue cataract surgery with a premium lens implant (IOL).

 

WHAT HAPPENS DURING SURGERY?

The procedure is painless and done under local eye drop anesthesia, usually taking 10-20 minutes, during which time the cataract is removed from the eye with microscopic instruments in a sterile operating room. The cataract is removed from inside a clear capsular sac that holds the natural lens inside the eye. A clear intraocular lens (IOL) implant is then inserted into the capsular sac. The eye typically seals naturally after surgery without the need for stitches.

After cataract surgery, vision improves rapidly and there is typically minimal to no discomfort. You may use your eye, wash your face, shower and do normal at-home activities the day of surgery. The day after surgery, vision is good to excellent and most individuals can drive and return to normal activity.

Cataract surgery results in safe and successful outcome in approximately 98-99 percent of eyes treated. Like any surgical procedure, there are risks. During your visit with Dr. Mitchel Wong, Dr. Shannon Wong or Dr. John Odette, the risks, benefits and surgical alternatives will be discussed with you. Fortunately, cataract surgery is one of the most common and safest surgical procedures performed in the U.S. today, with over 3 million procedures performed annually.

Approximately 50 percent of patients having cataract surgery choose basic fixed-focus lens implants. With such lens implants, reading glasses and/or bifocals are usually required to achieve one’s best vision after surgery. Approximately 50 percent of patients having cataract surgery choose state-of-the-art adjustable-focus lens implants to help them see younger and become less dependent on glasses altogether. The individuals who desire clear vision near, far and in between without glasses after cataract surgery can choose to upgrade to one of these state-of-the-art lenses.

When using a basic IOL we use basic traditional cataract surgical techniques which are extremely safe and successful. If patients choose a state-of-the-art lens implant or choose to have their astigmatism corrected at the time of cataract surgery, we use bladeless laser cataract surgery, which is designed to improve the precision and safety of many of the key steps in cataract surgery.

Video Simulator – Cataract IOL

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Cataract surgery for most of our cataracts Austin patients is performed at Austin Eye Laser and Surgicenter, located at our 11901 Jollyville Road building. This specially designed surgical center is dedicated exclusively to eye surgery and is equipped with the most advanced cataract surgery instrumentation and equipment available. The Austin Eye Laser and Surgicenter is certified by the Accreditation Association for Ambulatory Health Care (AAAHC) and Medicare.

For more information about cataracts and/or cataract surgery, please call 512-250-2020 or email the physicians on staff to schedule your initial consultation.