Cataract Surgery Options – Austin Eye

The Cataract Surgery Decision:

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 our dependence on glasses to refocus from far to near to increase. A cloudy lens is 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, perform normal daily activities and blur vision in general. Cataract formation is a normal unavoidable part of the aging process.

You have a cataract. That means that you have two decisions to make:

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:

• 1) Basic cataract surgery with a basic fixed-focus lens implant.
• 2) Laser cataract surgery with a state-of-the-art lens implant or laser cataract surgery to correct astigmatism. For Austin bladeless laser cataract surgery patients, we use a variety of lens implants that correct astigmatism and which enable individuals to focus on far and near objects without relying on glasses in most instances. Our laser cataract surgery also is used to correct astigmatism at the time of cataract surgery.

In general, there are "3 zones of vision" that we use to see the world around us: 1) Near (reading print on a piece of paper), 2) Mid-range (computer distance), and 3) Far (TV and street signs while driving).

A basic lens gives good vision at 1 of 3 zones. So if your eye receives a basic lens, it will see clearest far away, but less clear at mid- range and blurry for near. Basic lens implants do not correct astigmatism. Individuals with a basic lens will likely need glasses after surgery to correct the remaining astigmatism to see clearest far and near. In order for your eye to see all 3 zones, you will need glasses. Individuals receiving a basic IOL should expect a 90-95% chance that they will still wear glasses to read or bifocals to see their best. Approximately 5% of our standard IOL patients are glasses- free for all 3 zones of vision after cataract surgery to both eyes.

State-of-the-art lenses provide clear vision over a broader range of distances. They will provide at least 2 zones of clear focus. The Crystalens, for example, provides excellent vision far and mid-range for driving, watching TV and working at the computer. 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.

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.

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 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 2 reasons: 1) you are intolerant of the blur that the cataract creates (.e.g., difficulty driving, reading, seeing the world around you clearly, watching TV) or 2) you wish to improve your overall vision and reduce or possibly eliminate your dependence on glasses to see your best. 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 CATARACT SURGERY?

The procedure is painless and done under local eye drop anesthesia, requiring usually between 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% 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 US today with over 3 million procedures performed annually.

Approximately 50% of patients having cataract surgery choose basic fixed-focus lens implants for cataract surgery. With such lens implants, reading glasses and/or bifocals are usually required for achieving one's best vision after surgery. Approximately 50% 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 all-laser cataract surgery which is designed to improve the precision and safety of many of the key steps in cataract surgery.

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 for 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 or email the physicians on staff or attend one of our monthly seminars.