Honolulu, Hawaii – Cataracts are one of the most common eye conditions that occur among older adults. The aging process brings along eye changes that can adversely affect vision. Clouding of the eye lens, which gradually occurs over time, is known as cataract(s). As the lens becomes cloudier, vision gets hazier, and without eye surgery, a cataract sufferer can in some cases totally lose their vision.
The “ancient” procedures of cataract surgery involved removing the entire lens in one piece using a large incision on the cornea, or the transparent front part of the eye. Since then, the evolution of cataract surgery has allowed smaller incisions, availability of lens implants to replace the clouded lens, and quicker recovery period. Unfortunately, it is not possible to prevent or treat cataracts with medication. The only treatment is surgical removal.
Cataract surgery is a very simple and painless procedure that has many benefits. There are little to no risks, and it is generally the safest and most effective way to restore vision with no serious complications. After having the surgery, you will be allowed to return home the same day. The recovery time for a cataract surgery is very short as the tiny incision size allows the eye to recover faster.
What are the symptoms of cataracts?
- Decreasing vision with age
- Blurred or double vision
- Seeing halos around bright lights
- Difficulty seeing at night
- Vision that worsens in sunlight
- Difficulty distinguishing colors
- Poor depth perception
- Frequent prescription changes for glasses
- Difficulty reading
How are cataracts treated?
Cataracts are removed with an operation. It is an outpatient procedure that lasts about 20-40 minutes. You are in the operating room, however, for about 1 hour to allow for the placement of monitors and other preparation. The procedure involves the use of a small probe to liquefy the lens and remove it with a vacuum. An intraocular lens (IOL) is placed in the eye at the time of surgery. See below concerning the best IOL choice for you. You are relaxed with IV sedation, but can hear everything that is going on in the operating room.
What causes cataracts?
- Age
- Eye trauma
- Heredity
- Diabetes
- Some medications including long-term use of oral steroids
- Ultraviolet radiation
- Smoking
- Glaucoma
- Certain metabolic conditions
Are there any potential complications with cataract surgery?
While cataract surgery is one of the safest procedures available, there are rare potential complications. Possible complications include bleeding, infection, blindness, vitreous loss or the need for a second surgery.Vision loss occurs in about one in 500 cases. Remember that over 95% of patients are very pleased after cataract surgery. You will have an appointment the next day with Dr. McMann. Should you have a problem in the mean time (excessive pain, discharge or nausea), call the office at 808-377-4101 for instructions on reaching Dr. Michael McMann MD, day or night.
What to expect on surgery day?
When you get to our surgery center, you will change into a hospital gown and an IV line will be started. You will be given drops to expand you pupil. Most of this occurs in a private room where your family or friends are welcome to stay with you both before and after surgery.
What happens during the operation?
You are relaxed with mild IV sedation. You can hear everything that is going on in the room and Dr. McMann will explain what is happening all throughout the procedure. Generally eye drops are all that is needed for anesthesia, but sometimes an injection or even general anesthesia is utilized. During the approximate 20-40 minute operation, you look at a bright light. We ask you not to talk or move unless you are experiencing pain or you need to cough. Then let Dr. McMann know without moving very much. Most people feel nothing during the procedure and are amazed at how quickly it is over.
What happens after the operation?
You will return to the recovery room generally with a shield over the operative eye. Once you are feeling alert and it is clear that you are not nauseated or having other problems, you will be sent home. This usually takes 30-45 minutes after the procedure. Your post-op care will be explained thoroughly before you leave the hospital.
When will I be seen again after the surgery?
You will have an appointment the next day with Dr. McMann. Should you have a problem in the mean time (excessive pain, discharge or nausea), call the office at 808-377-4101 for instructions on reaching Dr. McMann, day or night.
What are Premium IOLs?
With cataract surgery, your natural lens is replaced with an artificial implant called an intraocular lens (IOL). A standard IOL maximizes your distance vision. This means that you still need glasses to see close up for reading or computer distance. Since standard IOL’s are only monofocal, they only correct the vision in one focal plane and do not address the presbyobic state of the eye. Presbyopia is not corrected in standard cataract surgery with standard IOL’s.
You now have the option to choose a Premium IOL. This exciting new development allows you to turn back the clock and see well both far away and close up without glasses. In a recent study of patients implanted with these new Premium IOL’s, 80% reported never wearing glasses after their cataract surgery. In contrast, only 8% of those who had standard, distance-only IOLs were glasses free after their surgery.
We offer multiple types of Premium IOL’s. We analyze your hobbies and lifestyle to determine which one best suits your visual needs
It sounds great, are there any drawbacks?
In the course of your day, you really are focusing at three different distances: far-away (driving or golf), intermediate (computers, countertops, newspapers or hobbies) and very close (small print books or maps). No one Premium IOL allows you to see all three distances clearly. All of them offer good distance vision coupled with either good intermediate or good close reading vision. The bottom line is that you may need thin glasses on occasion for some activities.
If you do a lot of night driving, the Premium Multifocal IOL’s may not be a good choice for you as you may experience glare at night. However, the AcrySof Toric Premium IOL would provide an excellent choice if you do a lot of night driving.
Another disadvantage is cost. While your actual cataract surgery is probably covered by insurance, Medicare or most insurance companies do not cover the added fees associated with the Premium IOL’s. These fees are for the extra testing necessary before surgery, the added cost of the Premium IOL, and the extra corneal surgical step needed in most cases at the time of surgery. However, if you dislike glasses, wouldn’t it be worth it to be able to see both close up and far away without them after your cataract surgery?
A final possible disadvantage is that you may require a slight refractive adjustment to your vision after the cataract surgery with LASIK vision correction. There cannot be any residual near-sightedness, far-sightedness, or astigmatism after the cataract surgery for the Premium IOL’s to work optimally. Should any of these refractive problems still be present after the cataract surgery, the LASIK adjustments would be provided at a very discounted rate.
Are there any other options?
Another possibility for those interested in decreasing their dependence on glasses after cataract surgery is monovision. With this option, we choose the IOL so that one eye sees well far away and the other sees well for reading close up. There are no added expenses for monovision with traditional IIOL’s, but you would experience a decrease in your depth perception. This would be a poor choice for those who enjoy golf, tennis or other activities where depth perception is important.
The AcrySof Toric IOL provides an excellent choice for patients who have corneal astigmatism and would like to choose monovision as a way of freeing themselves from having to need glasses. The single focus vision provided by these IOL’s is superior to that from the traditional monofocal IOL’s.
What should I do? Which IOL is best for me?
Consider your visual needs and how you feel about glasses. The Premium IOL’s are ideal for those with active lifestyles who are annoyed by glasses. They allow you to turn a potentially negative condition, cataracts, into an opportunity to expand your vision.