Cataract Surgery

What is a cataract?

A cataract is a “clouding” of the eye’s natural lens, which results in blurred or defocused vision. According to a recent article published in the Archives of Ophthalmology, more than 20 million adults in the U.S. have developed cataracts making it the number one cause of poor vision in the United States. While not all cataracts require surgery, nearly 3 million cataract procedures are annually performed in the U.S. According to the National Eye Institute, the number of Americans with cataracts is expected to rise to over 30 million people by the year 2020.

What causes a cataract?

Can cataracts be prevented?

Cataracts cannot be prevented and are the leading cause of treatable blindness worldwide.

How is the procedure done?

The eye is anesthetized to ensure the patient’s comfort during the procedure.  The natural lens is removed by using ultrasonic vibrations through a micro-incision of 3mm or less in length.

The natural lens is replaced by a foldable monofocal or multifocal intraocular lens, which is inserted through the micro-incision.

The lens spontaneously unfolds, similar to a butterfly opening its wings, as it is placed into permanent position.  No stitches are required because the small incision is self-sealing.

The procedure is usually done as an outpatient procedure in an ambulatory surgery center.  The only difference between cataract surgery and refractive lens exchange surgery is that cataract surgery is performed to remove a patient’s cloudy lens and refractive lens exchange is performed to reduce one’s dependence on glasses or contact lenses.

How long has Dr. Parent been performing cataract surgery? 

Dr. Parent performed his first phacoemulsification surgery, or removal of cataract by ultrasound, in 1975.  Dr. Parent participated in the first FDA study on a multifocal lens in 1984.  In 1991, Dr. Parent began performing sutureless, clear corneal incision cataract surgery.

What is the difference between a monofocal and a multifocal intraocular lens?

A monofocal lens corrects only one distance, so you will still need to wear glasses after the surgery to see at other distances.  A multifocal lens can improve your distance, intermediate, and most of your close vision.  The purpose of a multifocal lens is to be less dependent on glasses.  This multifocal lens does not rebirth the patient but does allow them remarkably improved vision at most distances.

The monofocal lens is the standard lens used in cataract surgery and is covered by Medicare or private insurance.  If the patient chooses the multifocal lens to be less dependent on glasses, the patient is responsible for the cost of the upgraded lens.  Neither Medicare nor private insurance will cover the cost of the upgraded lens.

Does the lens move in the eye?

The lens does not move in the eye.  It is held in place by locking itself into the capsule.  The capsule is the liner, similar to Saran Wrap, which held the eye’s natural lens in place.

Can cataract surgery correct astigmatism?

No, but the surgeon can make limbal relaxing incisions in the surface of the cornea to reduce the astigmatism at the same time the cataract surgery is being performed.  These incisions can reduce or eliminate the astigmatism.  There are also intraocular astigmatic lenses, but they are not produced in multifocal platform at this time.

Can both eyes be done at the same time?

No, the eyes should not be done at the same time because it is an invasive surgery.  The doctor wants to make certain the operative eye is healing correctly before proceeding with the second eye.  The first eye to be done is usually the patient’s non-dominant eye or worst cataract.

Are you asleep during the surgery?

No, the patients are very sleepy but remain somewhat awake so that they can cooperate during the procedure.  They are given medication to help keep them relaxed and the eye is anesthetized to ensure the patient’s comfort.

How long does the procedure last?

The procedure itself can last anywhere between ten to forty minutes varying with each individual.

What is the healing time after cataract surgery?

The patient is allowed to perform their routine, daily tasks immediately after the procedure, but it could take up to three months for them to adjust to their new vision.  Their vision can continue to improve for up to one year.

Will the cataract come back?

No, the cataract will not come back.  During cataract surgery, the surgeon removes the natural lens, which has caused the cataract, from its cellophane-like lining called the lens capsule.  Weeks to years after cataract surgery, the capsule may become cloudy or wrinkled and cause blurred vision.  A posterior capsulotomy is a simple laser procedure that makes an opening in the back, or posterior, part of the capsule to restore your normal vision.

Will the intraocular lens implant need to be replaced?

As far as studies show, intraocular lenses last beyond a lifetime.  The need for replacement is not an issue.