Delaware Cataracts Doctor
What are Cataracts?
Cataracts are an age-related process that affects the intraocular lens inside your eye. As we all age, the proteins inside the lens become hardened and cloudy. This disrupts the clarity of our vision by causing blurriness, glare, trouble with night driving.
This process can occur sooner in glaucoma patients secondary to chronic use of glaucoma drops or from previous glaucoma surgery. In an eye with a narrow angle, a cataract further narrows the angle recess. In such eyes, removal of the cataract alone will widen the anterior chamber angle and help prevent an acute angle closure attack.
Cataract Surgery
Removal of the cataract is a surgical procedure. A tiny incision is made in the clear part of your eye called the cornea. A circular opening is made in the “bag” (capsule) which holds the cataract. A probe is inserted into your eye through this incision. This probe breaks up the cataract into tiny pieces using ultrasound energy. The cataract debris is removed using an automated irrigation-aspiration system. Once all the lens material is cleaned out, an intraocular lens implant (IOL) is placed into the bag. The artificial lens implant is placed in the natural anatomic position and it stays there for life. If the capsular bag is unstable (which is more common is some glaucoma patients), your doctor may chose to implant the IOL in a different position felt to be safer. On completion of the procedure, your doctor may place a stitch through your corneal wound, particularly if it combined with a glaucoma procedure; this stitch is easily removed in the clinic without any discomfort.
Intraocular Lens Options
What are my lens implant choices?
In preparation for cataract surgery, certain measurements are taken of your eye to determine the correct power of the lens or IOL to be placed in your eye at the time of cataract surgery. The axial length of the eyeball along with the corneal curvature is measured. Based on the measurements, various IOL choices will be presented to you. In general, there are 3 types of IOL choices:
Monofocal Lens Implant
This is the “standard” lens that is covered by insurance without additional cost to the patient. It has the ability to correct your vision at distance (most commonly preferred by patients) or near, but not both. Often, reading glasses are needed for up-close vision. This lens is not able to correct astigmatism.
Toric Lens Implant
This lens is able to decrease or eliminate your astigmatism (astigmatism causes distortion of vision if not corrected). However, similar to a “standard” lens above, it cannot correct both distance and near vision, and most patients will require reading glasses for up-close vision.
Multifocal Lens Implant
This lens has the ability to improve BOTH your distance and near vision, decreasing and possibly eliminating the need for glasses. Not everyone is a candidate for this style of lens, and it is not covered by your insurance. This means that there is an additional charge for the lens that you would be required to pay.
Cataract and Glaucoma Surgery
Cataract surgery in glaucoma patients presents the ophthalmic surgeon and the patient with many potential problems. One of the most important is the perception of cataract surgery as a quick-fix operation with a rapid return of splendid vision for all patients. This is often not true for glaucoma patients undergoing “routine” cataract surgery. The management approach in the patient who has both glaucoma and cataract must be in many ways totally different from that of a person with cataracts uncomplicated by glaucoma.
Fortunately, surgical techniques for both diseases have improved greatly over the past decade, and surgeons with up-to-date expertise in both subspecialties can provide superior outcomes for their patients. Our Delaware cataracts doctor, Dr. Dealy is fellowship-trained in the management of cataracts and glaucoma surgeries.
YAG Capsulotomy
At least 50% of cataract surgery patients will need to have a laser in the months to years following their surgery. This is due to a gradual clouding of the capsule or bag that holds up the replacement lens. It is not due to the cataract coming back or growing over the front of the eye. This procedure can be performed in the office and does not require the patient to have anesthesia.
MIGS
The most common addition to cataract surgery for patients that have mild to moderate glaucoma is the placement of the Istent ™ or the Hydrus ™ stents. These tiny, nearly microscopic implants are placed in the Trabecular Meshwork or drainage angle of the eye at the time of cataract surgery. The stents are capable of lowering the eye pressure, but at this time are only approved for use with cataract surgery. While they are an implantation of a medical device they do not affect or prohibit patients from having an MRI.
Cataract Surgery FAQs
How will I know if it is time for cataract surgery?
It is recommended that people have cataract surgery when their cataracts begin to impact their quality of life. If important activities such as reading or driving are becoming more difficult, it may be time to discuss cataract surgery with your doctor.
What happens if cataracts are left untreated?
Cataracts get progressively worse over time. Worsening cataracts lead to worsening vision, especially at night, as well as less vibrant colors and increased sensitivity and glare from light. Left untreated, cataracts can eventually cause blindness.
Can eye drops prevent or cure cataracts?
Currently, no eye drops are proven to prevent or cure cataracts and no eye drops have been approved by the Food and Drug Administration (FDA) to treat cataracts. The only option to correct cataracts is surgical removal and replacement of the lens.
How long does cataract surgery take?
The procedure itself ordinarily takes less than 20 minutes. The majority of time a patient spends at the surgery center is used in preparation for and recover from the anesthesia used during the procedure. In total, the process takes about two and a half hours.
Does cataract surgery hurt?
Cataract surgery is usually painless. The surgery is typically done with a local anesthetic and intravenous (IV) sedation. After the surgery patients may feel some discomfort and grittiness, but this pain is mild and well managed with over-the-counter pain medication. This soreness usually goes away over the first few days.
Are you awake during cataract surgery?
Yes, patients are awake during the procedure and are given a mild sedative to help them relax as well as numbing eye drops to prevent discomfort.
Can I eat before surgery?
No. You should not eat or drink anything 8 hours prior to surgery.
What will my vision be like after cataract surgery?
Most individuals see better within 24 hours after surgery and their vision continues to improve over the following days. It is also normal for some patients to experience blurriness after the surgery due to inflammation and swelling inside the eye. Your eye doctor will be actively monitoring your healing after the surgery, and in most cases this blurriness will go away on its own within a week.
Will I have to wear an eye patch?
When you leave the surgery center your eye will be covered with an eye shield. That shield is used to help prevent you from rubbing or causing damaging to your own eye. We ask that you continue to wear the eye shield at nighttime the following week, so that you do not accidently rub your eyes while you sleep.
How much time do I need to take off from work?
The recovery process for cataract surgery is relatively mild and most patients can return to work as normal two days after surgery.
Can I wear makeup after cataract surgery?
All eye makeup should be avoided for at least one week after surgery. Face makeup, especially powders and foundations can also make their way into the eye and should be avoided while the eye is healing.
Can I take a shower and wash my eyes after surgery?
Yes, you can shower and wash your hair as soon as one day after surgery. However, you should keep soap and water out of your surgery eye and avoid applying direct pressure to the eye.
Can I exercise after cataract surgery?
Yes, you can resume light workouts like walks or bike rides on the day after surgery. However, heavy workouts like lifting or running as well as activities that get your head wet like swimming or hot tub use should be avoided for at least a week.
Will I ever need to repeat cataract surgery?
No. The new lens that is implanted during cataract surgery is very durable and will last a lifetime. About 50% of patients do develop a cloudiness in the capsule that holds the lens in place. This “secondary cataract” or posterior capsule opacification (PCO) can be easily removed with an in office laser procedure known as a YAG capsulotomy.
Will I need glasses after cataract surgery?
After cataract surgery, most patients will still need glasses. However, since cataract surgery alters the structure of your eye and can cause changes in vision, it is recommended that you wait until your eyes are completely healed before getting a new prescription for glasses.
Schedule Your Appointment with a Delaware Cataracts Doctor
If you are experiencing persistent loss of vision, schedule an appointment with us so that we can assist you in determining what is the cause of your visual impairment. Cataract surgery can help restore your vision, so you can return to life as usual.