With the information of a cataract, activities like reading, bowling, or driving can be difficult. Fortunately, vision can be restored quickly, allowing the patient to return home within a few hours. With new advances in cataract surgery, noticed vision improvement begins almost immediately, and an eye patch isn’t even needed.
WHAT IS A CATARACT?
A cataract is the clouding of the lens of the eye. Normally, light passes through the clear lens and is focused onto the retina. However, as a result of the natural aging process, the lens gradually becomes cloudy. The cataract or cloudy lens blocks the passage of light through the eye and causes distorted or blurred vision.
Once a cataract has formed, the most effective way to restore vision is to remove the cloudy cataract and replace it with a plastic lens implant (Intraocular lens or IOL).
NOTE: Lens implants provide excellent vision and require no care after cataract surgery.
With recent advances in cataract surgery equipment and techniques, vision can be restored safer and faster, allowing patients to resume normal activities within hours after surgery (some activities may be limited during healing). Using these state of the art techniques, cataract surgery has a success rate greater than98%.
TOPICAL or NOT NEEDLE ANESTHESIA
Previously, cataract surgery was preformed under general anesthesia requiring patients to stay in the hospital. Later advances used a local anesthesia (retrobulbar or peribulbar blocks) where a needle stick is made, penetrating to just behind the eyeball where the anesthetic is injected. Although this procedure allows patients to return home the same day and is safer than using general anesthesia, it is not entirely free of risk.
Today, with recent advances in cataract surgery anesthesia, topical anesthetics are used. A patent may be given a sedative to help them relax and to keep them comfortable during the procedure. Next, the eye is anesthetized with eye drops instead of needle injection.
ADVANTAGES OF TOPICAL ANESTHESIA
· Faster with greater patient comfort
· No patient anxiety over receiving a deep injection next to the eyeball.
· Visual recovery begins immediately since the eye muscles aren’t paralyzed as with local block anesthesia.
· Eliminates potential complications such as perforation of the eye, hemorrhage or damage to the optic nerve.
· Removes the chance for a relatively dangerous anesthesia induced allergic reaction.
· Eliminates potential for postoperative headaches caused by conventional blocks.
· Eliminates need for an eye patch.
NO-STITCH, SELF SEALING INCEISION SURGERY
Ultrasound technology (phacoemulsification or “phaco”) is often used to remove a cataract. With “phaco,” the probe is inserted through a small 1/8” opening (instead of a relatively wide incision) created with a specified self sealing technique. The new techniques place the incision into the cornea (clear part of the eye the covers the iris or colored portion of the eye) just next to the sclera (white part of the eye).
ADVANTAGES OF THE NO-STITCH, CLEAR CORNEAL INCISION
· No placement or removal of sutures
· May be performed under local or topical anesthesia
· Requires No Patch when combined with topical anesthetics
· It is a bloodless incision
· Reduces postoperative restrictions
· Improves postoperative vision and minimizes postoperative astigmatism.
Ultrasound is used to gently break-up (or emulsify) the cloudy lens into tiny pieces which can be removed through the tip of the “phaco” probe instead of a wide incision. A special lens can then be implanted through the smaller incision.
Many patients are pleased to find that after topical, clear corneal cataract surgery their vision improvement begins almost immediately, and they return home within a few hours after the procedures. Patients may find their vision better than ever; however, some will need to wear glasses for reading and other activities following the procedure. During the initial healing period there may be few limitations on strenuous activities. However, most people find they are able to return to a normal lifestyle immediately, plus start doing things poor cataract vision had restricted them from doing in the past.
During cataract surgery a clear capsule is left in place to support the lens implant. In some cases this capsule may turn cloudy months or years after surgery creating a “secondary” cataract. If this occurs an outpatient laser procedure will quickly restore good vision.
IS TOPICAL ANESTHESIA, NO-STITCH, NO-PATCH CATARACT SURGERY FOR EVERYONE?
In most cases the topical anesthesia, no-stitch, no-patch techniques are preferred, however some patients, because of their eye structure, health or other factors, may not be good candidates for the new techniques. In these cases, patients can have traditional surgery and expect to do well. A complete eye examination and consultation with the doctor is necessary to determine each individual’s specific needs and potential for improved vision.
SIGHT LOSS CAN BE PREVENTED
Loss of sight from the cataracts is usually preventable. With modern technology, cataracts can be removed and good vision restored when a person feels the loss of vision is great enough to interfere with daily activities.
If you care experiencing the symptoms of cataracts or other vision problems, you should obtain a complete eye examination.