Cataract surgery is a fairly common procedure to remove a cloudy lens, that is a cataract, from inside the eye to restore vision. The cloudy lens inside the eye is replaced with an artificial lens or intraocular lens (IOL). Cataracts generally occur as a natural aging process. However, they can also occur at birth (congenital) or caused by a drug, chemical, or physical injury. Cataracts may go unnoticed at the onset because the cloudiness presents gradually and vision is only mildly affected. Eventually, cataracts worsen and begin to impair vision, and ultimately require cataract surgery.
Advanced Technologies for Cataract Surgery
At Fort Worth Eye Associates, Dr. Ann Ranelle constantly strives to achieve outstanding vision results for each patient by understanding their individual needs and comfort. Fort Worth Eye Associates offers advanced technologies for choosing the appropriate lens implant and treatment plan for each patient.
Signs and Symptoms of Cataracts
Cataract symptoms often present so gradually that they go unnoticed for a time. Vision is not particularly affected during the early onset of a cataract. Cloudy or foggy vision is the symptom most associated with cataracts, however other signs that may signal cataract formation include:
- Night vision difficulty
- Dim or blurred vision
- Glare or light sensitivity
- Difficulty reading small print
- Seeing light “halos”
- Colors appearing to fade or yellow
- Difficulty distinguishing color shades
- Double vision in one eye
- Frequent vision prescription change
How Cataracts Form
Cataracts form when, as we age, the lenses of our eyes (located behind the irises, or colored portion of the eyes) become thicker and less flexible causing eye tissue to break down and cloud the lenses. As light enters the eye, the lens produces images onto the retina at the back of the eye. As more of the eye tissue breaks down, the cloudiness (cataract) scatters the light entering the lens and the images become less sharp thus blurring vision.
Cataracts generally occur in both eyes at a similar but not identical rate, but in some cases, may affect only one eye. Because cataracts often develop at a slightly different pace, one eye may require cataract surgery before the procedure is necessary on the other eye. Typically, cataract surgery for both eyes is not performed at the same time but is scheduled a few weeks apart, correcting the more affected eye first.
Types of Cataracts
- Nuclear cataracts: Cataracts that affect the middle of the eye lens and characterized by increased nearsightedness at the onset, then a yellowing to browning of the lens that can make distinguishing color shades difficult.
- Posterior subcapsular cataracts: Cataracts that typically form at the back of the lens, interfering with the light’s path and usually causing reading difficulty, poor vision with bright light, and a halo or glare effect around lights at night
- Cortical cataracts: Cataracts in which streaks or wedges begin on the outer lens of the eye and progress to the center of the lens interfering with light entry and typically causing glare problems
- Congenital cataracts: Cataracts which are present at birth often due to prenatal infection in the mother or a congenital medical condition such as rubella, myotonic dystrophy, Lowe’s syndrome, or galactosemia
While cataracts are part of the aging process, there are other factors that may increase the risk of developing cataracts, including:
- Family history of cataracts
- Diabetes
- Obesity
- Excessive alcohol consumption
- High blood pressure
- Frequent sunlight exposure
- Ionizing radiation exposure, such as x-rays or radiation therapy for cancer
- Smoking
- Prolonged use of certain medications, such as corticosteroids
- History of eye inflammation, injury, or surgery
Diagnosing and Treating Cataracts
Diagnosing cataracts will begin with having a routine ophthalmic exam. Your ophthalmologist can determine if you have cataracts during these tests, which may include:
- Visual acuity test (eye chart)
- Retinal exam: Involves dilating the eyes with special drops to determine the health of your retinas
- Slit-lamp exam: Magnifies the front portion of the eye to allow detection of abnormalities
If your doctor determines that cataracts are present, cataract surgery treatment will depend upon the severity of your visual symptoms. For mild cataracts, your doctor may take a watchful approach and recommend a reexamination at a later time to evaluate cataract progression. Very mild cataracts typically do not require surgery; only when the cloudy lenses adversely affect the quality of life is surgery performed.
Having an up-to-date vision prescription and using bright lighting whenever possible will ease cataract symptoms early in the process, however, when vision problems become more noticeable and begin to interfere with daily activities, cataract surgery will be necessary to restore sharp vision.
Cataract Surgery in Adults
Cataract surgery is one of the most commonly performed operations worldwide and is considered to be an extremely safe and effective outpatient procedure. During cataract surgery, your doctor will numb the eye with local anesthesia, remove the cloudy lens of the eye, and replace the lens with a clear artificial lens called an intraocular lens (IOL).
At Fort Worth Eye Associates, we offer several types of lens implants:
- Standard implant (monofocal lens): Common IOL that corrects vision in one area, usually distance. Vision will be unclouded, however, reading glasses may still need to be worn as they were before cataract development
- Premium implants (accommodative or multifocal lens): Revolutionary new IOL which uses the latest technology in correcting vision after cataract surgery. Premium implants allow both distance and near vision to be corrected and greatly reduce the need for eyeglasses. Fort Worth Eye Associates offers these premium intraocular lens options.
The First and Only Lens That Can Be Customized AFTER Cataract Surgery
With traditional intraocular lenses (IOLs), your physician performs measurements before your surgery in order to select the best IOL to try to achieve your vision goals. Once your surgery is complete and the IOL has been implanted, your physician has limited options to adjust the lens power.
With the RxSight™ Light Adjustable Lens, you and your doctor can now customize your vision after your eye has healed from cataract surgery. This is because the Light Adjustable Lens is made of a special photosensitive material that changes the shape and power of your implanted lens in response to ultraviolet (UV) light. You and your physician will have the unique ability to adjust and preview your vision until it meets your personal desires and lifestyle requirements.
The cataract removal and IOL implantation procedure is the same as if you selected a non-adjustable IOL. Then, in the weeks that follow, your physician will customize your vision through a series of non-invasive light treatments that take only a few minutes each. You may need 3 to 5 total light treatments over a period of 1 to 2 weeks to reach your vision goals. Once your vision is adjusted, a final light treatment is used to lock in the results.
The Light Adjustable Lens delivers superior vision outcomes that non-adjustable IOLs cannot match. In a clinical study, the majority of patients who received the Light Adjustable Lens achieved 20/20 or better vision at 6 months without glasses.1
1. US Food and Drug Administration. Summary of Safety and Effectiveness (SSED) of Light Adjustable Lens and Light Delivery Device system.
Light Adjustable Lens Fast Facts
· The first and only adjustable intraocular lens (IOL) that allows your physician to customize your vision after your cataract surgery
· Patients who received the Light Adjustable Lens followed by adjustments were twice as likely to achieve 20/20 vision at 6 months without glasses as those who received a standard monofocal IOL
· The cataract removal and IOL implantation procedure is the same as if you selected a non-adjustable IOL
· The Light Adjustable Lens is made of a special photosensitive material that changes the shape and power of your implanted lens in response to ultraviolet (UV) light
· You will have the unique ability to preview and compare possible vision outcomes based on your preferences and lifestyle requirements
· Light treatments that precisely reshape your implanted lens are delivered in your doctor’s office to adjust your vision to the desired target
· Light treatments are painless, non-invasive, and last approximately 90 seconds
· You may need 2 to 4 total light treatments over a period of 1 to 2 weeks to reach your vision goals
· You will need to wear special UV protective glasses during all waking hours (from time of lens implantation until after the last light treatment is completed) to prevent exposure to indoor and outdoor sources of UV light that can cause uncontrolled changes to the Light Adjustable Lens
UV Protective Glasses (Language)
Exposure to indoor and outdoor sources of UV light can cause uncontrolled changes to the Light Adjustable Lens until all light treatments are completed. To prevent this, patients must wear special UV protective glasses provided by RxSight during all waking hours (from time of lens implantation until 24 hours after the final lock-in light treatment is completed).
The clear pair of protective glasses must be worn indoors, and the tinted pair must be worn in all bright sunlight conditions. The glasses may be removed when sleeping, and may be temporarily removed when showering, washing the face, or applying eye drops as long as the patient is not exposed to direct sunlight.
Unprotected exposure to UV light during this period can result in unpredictable changes to the Light Adjustable Lens, which might necessitate removal of the lens.
Postoperative Recovery for Cataract Surgery
Postoperative recovery for cataract surgery usually takes just a few days, during which you may experience some mild eye discomfort. You will be given a protective shield for your eye which your doctor will instruct you when to remove and when to replace. The eye shield is generally used during sleep for several days. Vision may seem blurry when the eye shield is first removed. This distorted vision is normal while your eye becomes accustomed to the intraocular lens.
Some patients experience red or bloodshot eyes, which resolves quickly as the eye heals. Clear vision can return within several hours or may take 1-2 weeks to be completely restored. While you will probably feel able to return to normal activities shortly after your cataract surgery, you should follow these tips to expedite your recovery:
- Do not drive on the day of your cataract surgery
- Be careful not to bump into anything
- Avoid activities that put pressure on the eye (lifting heavy objects, bending down, strenuous activity, sneezing, vomiting)
- Do not rub the eye
- Avoid eye irritants, such as wind, dust, and smoke
- Do not swim or use a hot tub the first week after eye surgery
After your cataract surgery, your doctor will give you detailed postoperative instructions and answer any questions you may have, and you should feel free to contact our office with questions or concerns at any time during your at-home recovery. A follow-up appointment will be scheduled after your cataract surgery to check on the progress of your healing, which is generally completed within 8 weeks.
If you are experiencing symptoms of cataracts or vision problems of any kind, contact our office for a complete eye evaluation. Our goal at Fort Worth Eye Associates is to achieve the best possible vision results for every patient through the use of advanced technology and by understanding the unique needs of each individual.
If you would like to learn more about cataracts visit our Cataract Surgery FAQs – Frequently Asked Questions along with answers for our patients with cataracts and please call our Fort Worth office at 817-732-5593.