A cataract is a clouding of the eye’s naturally clear lens. When the natural lens experiences this clouding effect, vision quality is diminished. Typically, the lens has a yellowish hue to it; vision becomes hazy, and clarity of night vision weakens. Many people describe this sensation as looking through a foggy car window or a piece of wax paper. Cataracts can be especially burdensome to people who have had clear vision most of their life.
The lens in your eye is responsible for focusing light rays on the retina, which is the part of the eye that senses light and transmits these images to the brain. When the natural lens becomes cloudy light rays cannot properly pass through. Vision becomes blurry, and as the cataract develops it becomes increasingly difficult to see.
A cataract can develop in one or both of your eyes and surgery is usually required to remove the cataract. Cataracts are part of the normal aging process and tend to develop slowly. However, when your ability to perform ordinary daily activities is affected - such as reading and driving, it is time to consider cataract surgery.
If you think you may have cataracts, it is important to talk to your family eye care provider, and schedule an appointment so he or she can evaluate your vision. If surgery is necessary, Minnesota Eye Consultants offers the most progressive, no stitch cataract surgery technology, as well as state of the art lens implant options.
During cataract surgery, a small incision is made and the lens material is removed by using an ultrasonic probe. This is called phacoemulsification. The surgeon is then ready to implant a man made intraocular lens. The intraocular lens is a foldable lens that slides through a tube and then unfolds via the micro incision in your eye. The cataract surgeon then centers it. Typically, these lenses are made of materials like silicone and acrylic, which will not irritate your eye or induce an allergic reaction. After this happens, the surgery is complete and there are usually no stitches required when sealing the incision.
The procedure is performed on an out-patient basis at one of three Minnesota Eye Consultants Ambulatory Surgery Centers, and takes only a few minutes. Patients are free to return home to rest in comfort and avoid the inconvenience and expense of a hospital stay. In most cases, daily activities such as driving and reading can be resumed fairly soon thereafter.
Cataract surgery is considered one of the most highly successful procedures, with improved vision occurring in over 90 percent of cases. However, some people will still need glasses to enhance their vision. It is important to discuss your vision goals and expectations with your surgeon during your initial evaluation.
There are now lenses and techniques available that can correct vision at near, intermediate, and far distances, and we call these Premium Vision Options. The intraocular lens chosen, and technique used by your surgeon will vary depending on the type of visual outcome you are targeting.
Intraocular lenses, or IOLs, are implantable devices that replace the natural lens in the human eye. Technology has improved drastically in recent years, and the possibility for achieving optimal visual outcomes has never been greater. Today, IOLs can treat both cataracts and presbyopia. During your consultation, a Minnesota Eye Consultants surgeon will discuss the most appropriate IOL and treatment plan for your eye, and make you aware of the risks, benefits and realistic expectations for your improved eyesight.
Some patients choose to have good distance focus, and use reading glasses to help with near vision tasks. The device used to achieve this result is a monofocal Lens Implant. When light enters a monofocal lens, it is bent to a single focal point. Since the lens is monofocal, the light can only be bent to one focal point clearly. A surgeon can choose an IOL that focuses light best coming from distant objects, or a stronger powered IOL that focuses light better from near objects. However, light cannot be focused from both distant and near objects at the same time with a monofocal lens. Therefore, glasses are still needed for some activities.
Another potential method of vision correction is to have monovision. In this method, one eye is corrected for good distance acuity and the other eye is corrected for good near acuity. After a period of adaptation, these patients can see both distance and near without glasses with both eyes open. Most of these patients have undergone a contact lens trial simulating this vision to make sure they can adapt to it prior to having it instituted in their cataract surgery treatment plan.
If you have astigmatism and have been diagnosed with cataracts, a toric lens may be the best option for you. Astigmatism is the refractive error where people are unable to see objects clearly from a distance or up close. When you have astigmatism, the light is focused unevenly due to the shape of the cornea: the surface of the eye is oval shaped, like a football, rather than round like a baseball. This causes images to look shadowed or blurry. It used to be that there was not an option to have astigmatism correction built into the lens and cataract surgeons would typically perform refractive surgery or LASIK after the implant of the IOL. Now with the new technology of toric IOLs, cataracts and astigmatism can be corrected all in one surgery. However, this lens can only correct distance vision so reading glasses are needed for near.
Limbal Relaxing Incisions may also be used to treat astigmatism in cataract surgery. Limbal relaxing incisions are placed on the far peripheral aspect of the cornea (the limbus) resulting in a cornea that is more round. The astigmatism is thus reduced and vision is improved.
By the age of 40, most people start to experience issues with reading because the eye’s natural lens begins to harden. The inability of the lens to change shape and hence, it’s power, makes it increasingly difficult to see at close distances. Ultimately, a pair of reading glasses or a bifocal is needed. This is known as a loss of accommodation, or presbyopia.
Multifocal and accommodating lens implants offer the possibility for patients to see at near, far, and intermediate distances after cataract surgery, often without the need for glasses or contacts. While current technology is able to provide some range of focus, these lenses cannot replicate the amazing range of vision you had when you were 20 years old. Sometimes glasses for near are still required.
Laser-based cataract surgery is when a femtosecond laser is used to break the eye's natural lens into fragments for easier removal through an incision. A laser may also be used to make incisions into the eye during the cataract procedure. Minnesota Eye Consultants is one of very few ophthalmology practices in the country to have access to this technology and your surgeon will determine whether or not laser cataract surgery should be included in your treatment plan.
On occasion, an enhancement procedure is needed. If necessary, we can improve visual acuity even further after IOL implantation using a laser. For patients who choose a premium vision package, the enhancement will be done at no charge within one year following the initial surgery.
Some people will choose to further reduce their dependence on glasses after cataract surgery and Minnesota Eye Consultants is fully equipped to provide a wide range of laser vision correction options and services. Our physicians and surgeons are regarded as true leaders in the development of laser vision correction, from its early inception to approval of LASIK by the Food and Drug Administration, to continuing research, training and development.
It is essential to do your homework when considering any type of eye surgery, and to choose an ophthalmology practice that can treat and care for the whole health of your eye, year after year.
After cataract surgery, it is also possible to experience blurred vision and the sense that the cataract has recurred. This is referred to as a secondary cataract and is due to clouding of the thin membrane (the posterior capsule) that supports the lens implant. Secondary cataracts occur in up to 50 percent of patients after cataract surgery and can occur months or even years after the original cataract procedure.
A laser treatment, called a YAG capsulotomy, is performed to treat the secondary cataract. The YAG laser creates an opening in the central part of the posterior capsule, allowing light to pass through, resulting in fairly quick visual improvements. The procedure is quick and painless, and is usually performed in an office setting.
Unfortunately, no outcomes can be 100 percent guaranteed. It is possible that your eyes may take longer to adjust to multifocal or accommodating lenses and you may experience halos and glare - particularly at night. Such problems should improve over time and even with these difficulties, patients generally experience better vision than they did prior to having their lens implanted.
Due to the complex design of multifocal and accommodating lenses, they are usually not covered by your insurance and will carry an additional charge. Financing plans are available for most patients.
We appreciate the privilege and opportunity to care for your eyes. For more information on cataract surgery, your premium vision correction options, or our surgeons, visit www.mneye.com or call 952.888.5800.
For your eyes, see the best.
In order to better understand which type of post-cataract surgery lens would be most beneficial to your lifestyle we have created a self-evaluation test that can be submitted to our practice for review of your visual situation. Please fill out the form and we will suggest a lens that will meet your visual and lifestyle needs.