Cataracts and Cataract Surgery

Serving Baltimore, Lutherville and Towson, Maryland

Clear vision depends on the eye admitting light rays. The light brings images into the eye and when they focus clearly on the “camera film” (retina) at the back of the eye, the brain can interpret and name them clearly. Cataracts are an obstacle for the incoming light. The eye’s crystalline lens becomes cloudy so that not all the light reaches the retina. Cataracts are progressive and at first can be managed with eyewear, but for most people, cataract surgery becomes a good option when their decreased vision starts to affect their lifestyle.

What is Cataract Surgery?
Cataract surgery is a simple procedure with an excellent success record. The clouded natural lens is replaced with an artificial lens called an intraocular lens (IOL). It is done on an outpatient basis with a topical anesthetic that will make it a painless procedure. One eye is done at a time, with a short healing period in between.

After making a very small incision outside your field of vision, your eye surgeon will insert a tiny probe and use ultrasound to break up the natural lens. With suction, the pieces are easily removed, and through the same incision, the IOL is inserted and positioned correctly. You may have a protective shield to wear during sleep for about a week, and your eye surgeon will prescribe eye drops to be used several times each day for several weeks. For best results, it is very important that you follow your surgeon’s post-operative instructions exactly.

Find out about Cataract Surgery Home Care and Complications.

About IOLs
IOLs are very small and thin and are positioned in the same capsule that previously held the natural lens. In past years they were monofocal and provided very good distance vision while requiring the patient to wear glasses for intermediate and near vision. Now there are multifocal and accommodating IOLs, as well as other types of IOL to address astigmatism and eye protection. This technological improvement has created more choice as to which IOL is used to treat your cataracts.

• ReZoom™ and ReSTOR® are multifocal IOLs, both approved by the FDA in 2005. They provide clear vision at all distances and offer greater freedom from eyewear than any previous IOLs. Their two different technologies feature concentric zones or steps built into their structure and they do not change their shape (curvature).
• Crystalens® is an accommodating IOL, which means it is controlled by the same eye muscles that previously controlled the natural lens. They move it slightly forward for near vision and slightly back for distance vision. You would not feel this movement, any more than you feel the natural lens changing its curvature for near and distance vision.
• Aspheric IOLs are designed to provide better contrast sensitivity than other types of IOL. They are not as curved on the front surface, but flatten slightly around the periphery. An example is the Tecnis® IOL whose design is based on Wavefront data – the same type of eye information used by the WaveScan® system of CustomVue LASIK. This makes it a good IOL choice for those who drive a lot at night, as it gives clearer vision in low light conditions.
• Toric IOLs are designed to correct corneal astigmatism, a condition of blurriness at all distances caused by an ovoid corneal shape. Examples of toric IOLs are the Staar Surgical IOL, FDA-approved in 1998 and the AcrySof® IQ Toric IOL which received FDA approval in March, 2009.

For more information, see Questions about Intraocular Lenses.

Find out about Candidacy for Intraocular Lenses.

Filtering IOLs
Some IOLs filter out ultraviolet (UV) light, which is thought to contribute to the formation of cataracts. The eye’s natural lens filters out UV rays, and when the natural lens is removed, as in cataract surgery, UV protection can be restored by use of a UV-filtering IOL.

Some IOLs also filter out blue light which is thought to play a role in causing age-related macular degeneration. An example is the AcrySof Natural IOL which has a transparent yellow color similar to that of the eye’s natural lens. That color does not tint the entire visual field or change your quality of vision.

For more information on cataracts and their treatments, please see our page on Diagnosis: Cataracts.

If you are suffering poor eyesight due to cataracts, please contact us to schedule an appointment. Your eye surgeon will be able to advise you as to which IOL would work best for your individual eyes. At Katzen Eye Group, we perform over 1300 cataract surgeries every year, with excellent results.