Sunday, May 29, 2011

Lifespan of Astigmatism Lens Implants

Question: I had successful right eye, detached retina repair surgery in February 201l. I am now scheduled, 6/2011 for right eye cataract surgery and lens replacement to correct a cataract and astigmatism. I am 63 years old and except for high cholesterol, I am in very good health. How long should the AcrySof® Toric Lens Implant last? Is it the best or close to the best? How much should I expect to pay?

Answer: The AcrySof® Toric Lens Implant is made of the same material as all of the other AcrySof® Intraocular Lens Implants:  A highly biocompatible, flexible acrylic material that lasts for MANY MANY years. It was first FDA approved and made available in the United States in approximately 1994 with some 4 million or so having been implanted. So, there is a long clinical history-greater than 15 years-that suggests the life span is quite long. They are implanted in children and young adults and thus are expected to last a "lifetime" without degradation. It is regarded as an excellent toric lens but with any surgery it is the skill, experience and expertise of the cataract surgeon that determines the result. Fees for astigmatism correcting toric lens implants generally range fro $900-$1500 per eye.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, May 27, 2011

Lens Implants for Astigmatism

Question: I have astigmatism and am having cataract surgery. If I have the lens implants for astigmatism, will I ever need glasses for distance. I realize I will need glasses for reading and computer but will I ever need correction for astigmatism again?

Answer: Lens Implants for astigmatism correction after Cataract Surgery-or toric lens implants-help to correct vision at distance as you have stated. They correct the astigmatism portion of your prescription at all distances but do not replace the focusing ability required to see at arm's length or near. The question of whether or not you will ever need an additional correction for astigmatism really depends on whether or not the shape of your cornea changes over the years to come. For the vast majority of patients who have Cataract Surgery there is little or no additional change in prescription over time. There is a VERY slight predisposition toward a slight increase in what is called "against the rule" astigmatism-but it is slight over a relatively long time horizon and occurs because of the normal change in shape of the cornea with age-with or without Cataract Surgery.

So the simple answer to your question is that no one can guarantee that you will never need glasses for seeing at distance again but there is a high probability that you will be able to enjoy "glasses free" distance vision for many many years with an astigmatism correcting lens implant.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, May 23, 2011

Cataract Surgery and Lens Material Left Behind

Question: After cataract surgery I had to have another surgery to remove left behind lens material. I do not really understand how this happened or why. Is this unusual? Why me?

Answer: Leaving behind some small amount of lens cortex is unusual but happens from time to time. The incidence of this complication is approximately 0.02% after cataract surgery. Modern Cataract Surgery is quite safe and effective. It is highly complex, utilizes sophisticated technology and requires meticulous care and skill to deliver the outcomes and results we have to come to expect. As with any surgery there are always risks and potential cataract surgery complications that can occur due to whatever sets of anatomical and physiological variations exist from patient to patient. The diagnosis and action by your Cataract Surgeon reflect the necessary course to get you the best possible results and avoid an untoward inflammation or other secondary complications. Following his or her clinical advice will likely produce the best results for you.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, May 20, 2011

Cataract Surgery and Scleroderma

Question: I am 51 yrs old and have been on prednisone therapy for the past 3 years, due to Scleroderma and dermatamyositis. About 1 ½ yrs ago I started to notice a problem and was diagnosed with cataracts in both eyes. I was not really happy with the cataract surgeon that I saw at a large eye center. Also, had LASIK about 9 years ago. And, would the Scleroderma or dermatamyositis cause any issues with cataract surgery?


Answer: Cataract formation secondary to prolonged use of steroids is a known and expected side effect that increases with dosage. Generally, low doses of steroids daily, say 10 mg or less per day, may only increase the risk of Cataracts by 10% or so, the risk may increase to 30% if you take 10-15 mg daily and even to 80% if you need to take more than 15 mg per day. However, there really shouldn't be any unusual complications with Cataract Surgery secondary to the autoimmune issues you describe, although you may experience some longer than usual dry eye symptoms. Now, the fact that you have had LASIK does mean that there is a need to take very careful measurements for your intraocular lens implant (IOL) as previous LASIK surgery can make these measurements more complex. Your situation would be best handled by a top Cataract Surgeon who is also a LASIK Surgeon. In addition, if at all possible it would be quite helpful if you could provide your preoperative examination results, measurements and notes to the cataract and Refractive Surgeon you ultimately choose.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, May 19, 2011

Near Vision Monofocal Lens Implant

Question: I recently had left eye cataract surgery with a near vision monofocal lens and LRI for my astigmatism. The surgery was uneventful and at my 2nd post-op visit today my surgeon said that everything looked just great. I discussed with my surgeon my having some regrets having the near lens rather than the distance lens. When he asked which lens I wanted, I said I really didn't know and asked him what most others do when they are nearsighted. He said they usually choose the near vision lens, so I went with that.
I now know that the plan to use the near vision lens was made with me not totally understanding the differences. I am now not able to watch television (8 ft) or just to be able to walk around in the house without my glasses, which I was able to do before the surgery. I can no longer watch the beautiful birds on the bird feeders on my deck with out blurriness without my glasses. He said that he could extract the near lens and replace it with a distance lens and then do the other eye with a distance lens but it was up to me. My near vision without glasses in the surgery eye is clear and best at around 14", but this is much closer than I was used to reading at before my cataracts developed, so it is a bit uncomfortable, but I assume I would get used to that.

Even after talking with my cataract surgeon, I am still in a frenzy over this, trying to determine if I should stay with the near for both eyes or extract the current near lens and have both distance lenses. If I do the extraction and go with distance, at what range does the distance start and what kind of vision would I have in between? Will I need to wear my glasses for watching TV if I go distance? Do most nearsighted patients go with close vision lenses? Are nearsighted patients who go with distance correction happier. It is such a hard scary choice for me to make!!...and I know I have to decide in a week.It is not the end of the world if I do have to wear glasses pretty much full time, but not having to would be nicer, of course. Monofocals are the only choice I can make. I cannot afford multifocal's. Any info you can give me that would help me make the decision, would be appreciated.

Answer: The decision to correct your vision after Cataract Surgery primarily for distance or primarily for near is entirely an individual decision and not dependent on what other people do. It depends only on how you spend your day and whether the bulk of the activities you participate in require better vision for near or for far. The fact that you have not chosen a presbyopia correcting near vision lens implants and chosen a monofocal lens implant means that you will have to wear eyeglasses for one or more distances in order to see clearly. Since you were nearsighted before the surgery and thus had to wear glasses at lease to see at a distance, the choice of providing you with a near vision correction in the lens implant was not inappropriate. But, based on your comments it sounds like perhaps you have achieved too much near focusing ability with the lens implant. The best solution is to carefully measure and list the distances that you wish to see clearly at and provide them to your Cataract Surgeon. By giving him or her a list of distances at which you desire to see clearly, he or she will be able to approximate the lens implant power to be used in order to set clear vision for you for most distances. However, vision correction with a monofocal lens after cataract Surgery necessitates that you will need eyeglasses for one or more distances-you just need to choose which one or ones and tell your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, May 16, 2011

Cataracts and Glaucoma

Question: I was just told that I have a cataract and glaucoma - more pronounced in the left eye and a recommendation for surgery was made. I have tried several drops for glaucoma and have allergic reactions to them. What is the best way to handle this medical issue?

Answer: If you have a Cataract and Glaucoma that cannot be medically controlled then you may not have any choice other than Cataract Surgery. Cataract Surgery in fact is the only way to treat a Cataract. When you have Glaucoma-depending on the type of Glaucoma that you have-it is possible to treat the Glaucoma with certain types of laser treatments that can reduce the intraocular pressure. In addition there is a surgical procedure called ECP that can be combined with Cataract Surgery that can also be used to treat Glaucoma. This really depends on the type of Glaucoma that you have as well as the severity of the condition. Your best solution is to find a top Cataract Surgeon and follow their direction on the best course of treatment.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, May 13, 2011

Laser Cataract Surgery after RK and Retinal Detachment

Question: I've had Radial Keratotomy (RK) surgery and detached Retinas in both eyes.Would it be best if I have Laser Cataract Surgery?

Answer: Cataract Surgery after RK is made more complicated not so much by the need to make any modifications in the Cataract operation itself, but in requiring more detailed measurements and calculations for selecting the proper intraocular lens implant (IOL) power to help you achieve the best possible vision. The fact that you have detached Retinas in both eyes may prompt your Cataract Surgeon to arrange a preoperative consultation with a Retina Surgeon just to be sure that your Retinas are reasonably intact and stable before your cataract Surgery procedure-with or without Laser Cataract Surgery. The use of the Femtosecond laser to perform Laser Cataract Surgery is a new technique that allows the surgeon to direct the laser to perform several of the most technically difficult steps of Cataract Surgery rather than doing them manually. This has some promise of greater precision than manual Cataract Surgery for these steps but does not necessarily provide any greater safety profile for someone who has had RK and detached Retinas. Thus, if you have Cataracts that are starting to impair your vision to where it is impacting your ability to safely and comfortably conduct your daily activities, there is not necessarily any reason to wait to have Laser Cataract Surgery. The results of modern Cataract Surgery today are quite good. Your next step is to find a top Cataract Surgeon who is also a Refractive Surgeon as these combined skill and experience sets will be required for your consultation and measurements which are likely to be a bit more complex than routine Cataract Surgery.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, May 9, 2011

“After Cataract” and YAG Laser Procedure

Question: I have already had cataracts removed from both the eyes. Now I have blurry vision in my right eye. The ophthalmologist says that I have cataract and needs to have a laser treatment to clear my vision. What does this mean? Is there another form of cataract that is corrected by the laser treatment?

Answer: A Cataract is a clouding of the crystalline lens of the eye. The crystalline lens has a soft protein center and is surrounded by a “capsule”. A Cataract forms because the protein becomes cloudy. During a Cataract operation the cloudy material is removed and generally the “capsule” is left in place and is used to support the intraocular lens implant (IOL) that corrects your vision. Sometimes, the capsule can become cloudy and cause symptoms much like those of a Cataract including blurry vision, glare and even dimming of colors and detail. This phenomenon is called “posterior capsular opacification” and is sometimes referred to as a “secondary cataract” or “after cataract” and occurs in as many as 30% of Cataract procedures. To resolve posterior capsular opacification and clear the vision, Cataract Surgeons use a procedure called YAG Laser Capsulotomy or “YAG”. Using the YAG Laser your Cataract Surgeon can create a precise opening in the capsule along the visual axis that returns the vision almost immediately. The YAG Capsulotomy is a quick, painless procedure performed with eye drop anesthesia and for the vast majority of patients provides excellent results.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Sunday, May 8, 2011

Slanting Vision after Cataract Surgery

Question: I had cataract surgery in my left eye the other day. I see great but now everything is slightly slanted. I put a cup on the kitchen counter and it is slanted slightly left. Not so with my left eye which is fine. I am seeing the cataract surgeon again next week. Will this always be this way? I am fine with it but does that happen after this type of surgery?


Answer: If you are certain that the vision is "slanted" and not "wavy or bubbled or distorted or bent" then it potentially sounds like your complaint may have something to do with uncorrected or induced astigmatism. You do not say whether you had preexisting astigmatism before your Cataract Surgery . If you did and it was not corrected with an astigmatism correcting toric lens implant (IOL) or with Limbal Relaxing Incisions (LRI) then you will still have it and it will need to be corrected. It is also possible that depending on the type of Cataract Surgery technique that was used, a small amount of astigmatism could be induced by the surgery itself. Sometimes this is temporary and sometimes not. Make sure that when you return to your Cataract Surgeon for follow up you clearly explain what you are experiencing so that he or she can diagnose and address the complaint.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cornea Swelling and Cataract Surgery

Question: I had cataract surgery 4 days ago. The surgeon said I had cornea edema. My vision is still awfully blurry (has improved). I have the toric lens implant. Is the blurry vision normal and about how long does it take for the vision to be "better than before?"


Answer: A mild amount of corneal edema after Cataract Surgery is not terribly uncommon. A great deal of corneal edema that takes more than a few days or perhaps up to a week to clear is unusual and may suggest that there is a weakening of the "pumping" function of the cornea whereby it clears itself of fluid. The term for this is "pseudophakic corneal edema". Some Cataract Surgeons will attempt to "clear" the corneal edema by prescribing hypertonic saline eye drops to draw the water out of the cornea whereas others will simply wait to see if it gets better on its own. An important point is that you state it is improving and not getting worse. This is significant and favorable. If you are not already scheduled to do so and if you do not experience a considerable improvement with a week you should return to your Cataract Surgeon for follow up.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Saturday, May 7, 2011

White Spots after Cataract Surgery

Question: My dad had cataract surgery and after this his vision was blurred with white spots. The eye doctor then put a small opening in the lens, which I think might be what is the YAG laser capsulotomy but his vision is still blurred with white spots. Is this something that can be treated and what should he do?


Answer: You do not state whether the white spots your Dad sees are fixed and stable or floating and move around. In either case it would be important for your Dad's Cataract Surgeon to fully evaluate the reason for the continued spots and blur and identify whether the cause is in the Vitreous body behind the Lens Implant, the Lens Implant itself or perhaps in the Retina in particular the Macula. Your Dad's symptoms should be thoroughly reviewed with the Cataract Surgeon. If he or she is unable to provide a satisfactory answer then it might be worthwhile to schedule a second opinion with a top Cataract Surgeon in your area.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular, a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Contact Lens after Cataract Surgery?

Question: I am having cataract surgery on my right eye with a lens implant that will give good distance vision. My left eye is extremely nearsighted. My eye doctor wants to correct the left eye with a contact lens, not glasses. I'm reluctant to be totally dependent on a contact. Is it possible to get glasses with a corrective lens for left eye and clear glass for the right?

Answer: Let's assume that after Cataract Surgery that your right eye sees well at distance without the need for any optical correction. If your left eye still requires a considerable optical correction and thus a relatively strong prescription eyeglass lens, the difference between the two eyes may cause your vision to be quite imbalanced and very uncomfortable. This is because the eyeglass prescription for extreme nearsightedness actually minifies or makes images look smaller. Thus, even though the vision might be good in each eye-there may very well be a difference in image sizes that causes you considerable discomfort.

Patients who have markedly different prescriptions in each eye-a condition called anisometropia-often complain of dizziness and headaches and even other uncomfortable symptoms when they try to wear eyeglasses. One option as your Cataract Surgeon described is to wear a contact lens. This equalizes the image sizes between the eyes and you would not actually be totally dependent on the contact lens as we are assuming that you will have good vision after the Cataract operation on the right eye.You do not state your age or whether you have the beginning of a Cataract in the left eye. If so, it is only a matter of time before you will have surgery on the left eye with a lens implant and then both eyes will have equal image sizes. If there is no Cataract in the left eye, another option-if your Cataract Surgeon approves and feels that it is medically necessary and safe and preferred or you are intolerant to a contact lens-the Cataract Surgeon can perform a Clear Lens Extraction and Lens Implant on the left eye which would also create equal image sizes in both eyes. The last possible option-if there is no Cataract in the left eye and you are not likely to develop one in the foreseeable future, is to have a Laser Eye Surgery procedure such as LASIK on the left eye to correct the nearsightedness. This would not be the best option if there was any chance you would need Cataract Surgery in the left eye any time soon. Eyeglasses after Cataract Surgery when one eye is extremely nearsighted is not the best option

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, May 6, 2011

Multifocal vs. Toric Lens Implant IOL?

Question: I’ll soon have cataract surgery, and would like to have any comments about my choices. It’s my left eye (SPH +0.75 CYL -0.75 Axis 107) and I would like to get the multifocal IOL (rather than toric). I’m 87, and have been comfortable with drugstore spheres (1.25 for distance, and 3.00 for reading). I feel that it would be more convenient to have a single pair of toric eyeglasses (if desired) for all distances when more acuity is needed, rather than reading glasses. A friend in a somewhat similar situation recently chose toric IOLs, and suggests that I too might be better off with torics. Any comments would be appreciated.


Answer: There is a diversity of opinion regarding your choices here. There many other considerations in choosing a Lens Implant than simply the prescription. First, you do not state-and may not know-whether the .75 D of astigmatism you have is due to the corneal shape and thus “corneal astigmatism” or whether it is in the crystalline lens and thus “lenticular astigmatism”. This may or may not impact the decision. Second, you do not state-and may not know-the length or the position of the incision to be made to remove the Cataract and insert the Lens Implant. This too can impact whether you actually need an astigmatism correcting toric lens. Next, you do not state-and may not know-what your best level of correctable vision is and whether you have any trace of Age Related Macular Degeneration (AMD) which would not be uncommon in the average 87 year old person. Even with relatively “normal” healthy maculae, it is not uncommon to have a reduction in contrast sensitivity at 87 years old. Patients with reduced

Macular function-even if slight-may not do so well with multifocal lens implants. You do not state-and may not know-when you will need and have cataract Surgery in your second eye. Multifocal Lens Implants (IOL)s work best when they are implanted in both eyes. So, there are many open questions that really should be discussed with your Cataract Surgeon.

That said, there are a lot of “ifs”. If you had multifocal lens implants in both eyes, and IF you had astigmatism in the left eye that needed correction, it could be corrected with a procedure called Limbal Relaxing Incisions (LRI) after your primary Cataract Surgery and Lens Implantation-and IF you have strong Macular function it is possible that you would be able to see well at distance, arm’s length and near-OR you still might need help with reading vision. If you needed and had a toric lens implant, you would in all likelihood need some near and intermediate eyeglass prescription. A lot of “ifs”. Your next step is to consult the best Cataract and Refractive Surgeon you can find in your area and have a thorough examination and consultation so you can make this decision together.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, May 5, 2011

When to Have Cataract Surgery?

Question: How does one know it is "time" to have Cataract Surgery? I have heard it is better to wait until it is driving you crazy!!!


Answer: The decision on when to have Cataract Surgery is somewhat a personal one based on your vision and the hassle and inconvenience of not seeing clearly and functioning comfortably and safely. Depending on what you need or what you would like to do-drive, drive at night, see faces clearly, read signs in sunlight, see the clergyman’s facial expressions, etc.-you can decide to have a Cataract removed when it is annoying to you. Years ago patients had to wait for Cataracts to get “ripe” before they could be removed. Today, top Cataract Surgeons using modern Cataract Surgery techniques can remove a Cataract and insert a Lens Implant to correct your vision when it prevents you from doing things in your everyday life comfortably, conveniently and safely. You certainly do not have to wait, nor would it be particularly wise to let the Cataract progress to where it “drives you crazy.” Your lifestyle, daily routine and safety come first.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Toric Lens Implant for 87 Year Old?

Question: My 87 year old father will be having his 2nd eye cataract removal soon. He had the first cataract done 5 years ago with another cataract surgeon. This time the surgeon recommended a toric lens. This cataract specialist's nurse told my dad he had an astigmatism and they would need to use the toric lens. My Dad agreed, but now is wondering at his age, if this toric lens is absolutely necessary. When he had the first cataract surgery, they didn't use a special lens. We are willing to go ahead with the procedure, but would like your input as to the necessity of the special toric lens. Thanks for your help!


Answer: There first thing you should know is that toric lens implants to correct astigmatism weren’t available as an option 5 years ago when your father’s first cataract was removed and this may be the reason a conventional monofocal lens implant was used. Or, it could have been possible that even if they were available, your father didn’t have astigmatism in the first eye. People who have preexisting astigmatism-astigmatism before cataract surgery-will need to have their astigmatism corrected by one of three methods in order to see as well as they should after cataract surgery. People with astigmatism can wear eyeglasses after cataract surgery, have a second surgery to correct astigmatism called Limbal Relaxing Incisions (LRI) or have an astigmatism correcting toric lens implant (IOL) as part of the cataract surgery. The astigmatism needs to be corrected by one of these methods so that your father can see his best.

As we get older, the need to see clearly remains quite important, not only for our daily activities but also for our mobility and safety. You and your father have to decide which of the three ways is best for your finances, lifestyle and safety. Being dependent on eyeglasses to get out of bed in the dark or dim illumination can be a big deal-one missed step, one stumble on a rug can be a disaster-thus unless there is some compelling reason otherwise, seeking “glasses free” correction through the LRI or toric lens is a better option at 87 years old. ALL three options have cost-some greater than others, and only you and your father can decide.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Wednesday, May 4, 2011

Cataract Surgery Astigmatism Correction Techniques

Patients who have cataracts and astigmatism and are now considering Cataract Surgery need to understand that in order to see clearly at distance after their Cataract operation they will need to correct their astigmatism by either wearing eyeglasses, having a secondary surgical procedure called a Limbal Relaxing Incision (LRI) or have an astigmatism correction toric lens implant (IOL). According to researchers at the Baylor College of Medicine’s Cullen Eye Institute as reported in the March 2011 edition of the Journal of Refractive Surgery both Limbal Relaxing Incisions (LRI) and toric lens implants both produce similar results. While both types of astigmatism correction performed well for lower correction levels, at higher levels of astigmatism the toric IOLs produced better results. Another variable that may lean in favor of the toric lens implants for astigmatism is the amount of surgeon experience. For those surgeons with less experience with LRI, the toric implants would be preferred to produce the best results.

Tuesday, May 3, 2011

Common Causes of Cataracts

Many people wonder what causes Cataracts. For some, they are seeking to do whatever they can to prevent a Cataract from forming. For others, they are looking for ways of treating Cataracts that might not involve Cataract Surgery. Here are some things you should know about Cataracts and the risk factors for Cataract development.

First, the single most significant risk factor for developing a Cataract is your age. Senile Cataracts are the most frequent type of Cataract encountered by patients and they are related to the normal aging process. The data are clear that as we age, the likelihood of developing a Cataract increases so that people in their late 50’s and early 60’s may have about a 50% chance of developing a Cataract and for those aged 65-75 years old the likelihood increases to 60% or more. However, there are a number of risk factors that can increase the chances of or directly lead to the formation of Cataracts. These include:

Cigarette Smoking-There are many adverse health effects of smoking cigarettes and you can add and increased risk of Cataract formation to that list. Whether it is because smoking reduces the available of nutrients and oxygen required to keep the crystalline lens healthy or some other factor is not yet clear but smoking cigarettes is a problem.

Use of Steroids-There are a number of people who need to take prescribed steroids such as prednisone for long periods of time in order to quiet the symptoms of asthma or arthritis. It is not uncommon that the use of steroids for 1-2 years in moderate to high doses can increase the risk of Cataract formation. While taking low doses of steroids daily, say 10 mg or less per day, may only increase the risk of Cataracts by 10% or so, the risk may increase to 30% if you take 10-15 mg daily and even to 80% if you need to take more than 15 mg per day.

Eye Injuries and Trauma-Any external injury to the eye creating a blunt trauma or even certain chemicals can result in a Cataract somewhere later in time. Any internal or penetrating injury to the eye often results in a cataract forming immediately.

Exposure to Sunlight and Ionizing Radiation-Many studies have demonstrated a clear relationship between excessive exposure to sunlight and the formation of Cataracts. It is a well know fact that prolonged exposure to ultraviolet (UV) radiation from the sun may increase the risk of Cataract formation two fold.

Diabetes-People with diabetes are known to be at higher risk for Cataract development and often develop Cataracts at earlier ages. While the exact reason is unknown there is suspicion that accumulation of sugars such as sorbitol in the crystalline lens actually promotes the formation of Cataracts.

Obesity-Studies have demonstrated a relationship between being overweight and the development of Cataracts. Again while the exact mechanism is not clear there is suspicion that obesity is often accompanied by high blood glucose levels as well as possibly indicating a poor diet lacking in the benefits of the antioxidant properties of fresh fruits and green leafy vegetables. Thus diet can have an effect on cataract formation.

Floaters After Cataract Surgery

Question: I had cataract surgery about 1 month ago. Since then I have had numerous floaters appear in my eye. I had a floater previously which had faded. I want to be sure I am not doing something to cause more floaters--I swim laps and use goggles. Would the suction from the goggles cause more floaters to appear?

Answer: Floaters after Cataract Surgery or really any type of intraocular surgery are not terribly unusual-especially if you had a floater prior to the surgery. It is pretty unlikely that the mild suction pressure that you create with the swimming goggles is responsible for the increase in floaters. Now, if the floaters have increased and are accompanied by the appearance of flashes of light, the sensation of a curtain or veil before your eyes, the appearance of distortion or a "bubble" in your vision-you should immediately schedule an appointment with your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, May 2, 2011

Allergy to Lens Implant Material

Question: I am wondering what the lens implant (IOL) is made of? I have allergies to many things including possibly to some plastics that are used for IV's.

Answer: Historically Lens Implants for Cataract Surgery have been made of three or four types of materials including polymethylmethacylate, silicone copolymers, collagen-silicone copolymers and foldable flexible acrylic materials. Each of these classes of materials has been found to be highly bio compatible over many years of experience. That said, it would be very important for you to fully review your allergic history with your Cataract Surgeon. It is possible that your Cataract Surgeon might request some additional testing from an allergy specialist in order to make certain that there is no real risk of implanting a particular type of material and lens.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataracts and Astigmatism Correction

Question: I have Cataracts and astigmatism, worse in one eye. Would it be okay to put a toric lens in one eye and regular IOL in other eye?


Answer: Cataract Surgery with Lens Implants is performed to get you the best possible vision correction. In general the prescription in both eyes is somewhat symmetrical but not always. If you have preexisting astigmatism is one eye and not the other it is entirely possible that you would need to have an astigmatism correcting toric lens implant in only one eye. There is no increased risk or complications from implanting a toric IOL in one eye only if that is what is optically necessary to correct your vision. If you have consulted a top cataract surgeon for your examination the best thing to do is follow their recommendation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.c/om is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.