Cataract Surgery Lens Implants & Eye Surgeons for Cataracts Blog

Thursday, December 27, 2012

Blurry Film after Cataract Surgery

Question: I had cataract surgery in October and my left eye continues to blur or get a film over it. If I blink hard enough this seems to help. It also hurts at times. Is this normal? Should I visit my eye doctor or cataract surgeon?

Answer: Without a clinical exam to fully understand the range of possible reasons that you have a blurry film after your cataract surgery that clears when you blink, we can only offer the following consideration. What you are describing sounds like an abnormality of the tear film or the eye surface. This is not uncommon at all and occurs in as many as 30% of the patients having cataract surgery. It is often attributed to dry eye or inflammation of the eyelid margins called blepharitis although there could be many other reasons. Your best course of action is to return to your cataractsurgeon and ask him/her to evaluate your situation. In almost all cases there multiple ways to improve the eye surface and tear film depending on the actual cause. Be patient as it does require some trial to find the best therapeutic approach.

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 or 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.

Cataract Surgery with Diabetic Retinopathy

Question: I have a question about having cataract surgery if I have diabetic retinopathy. I have been diagnosed with diabetic retinopathy and am currently undergoing laser treatment. I am also beginning to develop a cataract and will need cataract surgery for this as well in the future. Are there any restrictions for cataract surgery if you have had laser treatment for diabetic retinopathy?

Answer: Cataract surgery and lens implants for patients with diabetic retinopathy can be performed successfully for the majority of patients but the ultimate results do depend on the overall health ad condition of the retina in terms of the progression and degree of treatment that has been rendered. First, it is critically important that a very careful and meticulous preoperative retinal evaluation confirm the level of vision that should be expected. One of the more common findings in diabetic retinopathy is the presence of Diabetic Macular Edema (DME) which can have a considerable effect of the level of best corrected vision that can be achieved-with or without cataract surgery. It is likely that your eye surgeon rendering the diabetic laser treatments is evaluating you for Diabetic Macular Edema with fluorescein angiography and ocular coherence tomography (OCT) testing. The presence of DME might actually be one of the reasons you are having diabetic laser treatment currently.

Diabetic Macular Edema is often treated with laser and/or vascular endothelial growth factor (VEGF) inhibitor injections such as Lucentis® as well as other medications. One of the concerns that many diabetics have is their susceptibility to slow or poor wound healing and infection. Modern cataract surgery is typically performed using eye drops for anesthesia rather than injections and through a very tiny self sealing incision-often between 2.2 and 3.0 mm. The precision and the architecture of this tiny incision allow it to close and heal without sutures in most cases. So, modern cataract surgery is actually quite “wound healing friendly” and requires no real modification in technique for diabetic patients. Depending on the stage of diabetic retinopathy at the time of your cataract surgery and lens implants, it is possible that your Cataract Surgeon or Retinal Specialist might place a vascular endothelial growth factor (VEGF) inhibitor injection such as Lucentis®, Eyelea® or Avastin® into the vitreous gel as a preventative and/or therapeutic measure. Assuming that you will not have had any retinal or vitreous hemorrhages prior to cataract surgery, and that the vitreous is otherwise healthy, other than these considerations and as long as any presence of macular edema has been accounted for in the setting of expectations for your ultimate vision after the cataract operation-you should have a relatively routine cataract surgery experience.

Thursday, December 13, 2012

Toric Lens Implant Rotation

Question: I had cataract surgery and an astigmatism correcting toric lens implant for a moderate cataract almost 6 months ago. I complained that my vision was way off after cataract surgery and I could see better when I tilted my head a lot. My cataract surgeon found the toric implant to be and said it needed to be corrected, which lead to a second surgery on same eye. I have been complaining for the whole time since then to my eye doctor and my cataract surgeon that my vision became blurry and I am not able to focus both eyes together-my vision is terrible. Now, my Cataract Surgeon tells me the toric lens implant rotated again and he will not reposition it as a thick haze has developed which makes it difficult to read and see with that eye. They recommend I have a laser treatment in the surgeon's office to help get rid of the haze, but once I do that I cannot have the lens repositioned. I am at a loss of what to do, as my vision is so terrible and I can no longer read. I have asked my eye doctor to send me to another eye specialist and surgeon for second opinion and recommendation but he said I have to finish with my current Cataract Surgeon. Help - is there something that can be done to improve my vision since the second time toric lens rotated it is still off.

Answer: Most Cataract Surgeons would not go back yet again and reoperate to correct the rotation of the toric lens implant-too much surgery. A YAG Laser Capsulotomy would BE THE LAST STEP to be taken after all other options for correcting your vision have been explored. There may very well be posterior capsular opacification or a secondary cataract causing the haze-or there may be other problems with the lens capsule causing the haze. It needs to be carefully determined. Also, a very careful refraction and examination of the amount and direction of the astigmatism present on your cornea needs to be observed. Further, a careful and thorough examination of your retina, especially the macula, needs to be performed to be certain that there is no swelling causing the distortion of your vision. One would suspect that the initial toric lens implantation was performed “off axis” as these lenses do not typically rotate excessively as you describe-but it could happen. You should find the best Cataract Surgeon in your area and seek a second opinion.

Retinal Detachment Risk after Cataract Surgery

Question: I am concerned about my risk of retinal detachment after cataract surgery. I am 75 years old, myopic, 75 yrs old and had retinal tears in each eye 13 years ago. What is the chance of retinal detachment after cataract surgery?? I am not ready to have cataract surgery yet but it is causing many sleepless nights

Answer: If it has been 13 years since the repair of your retinal tears-and they were treated with a laser at that time-one would assume that they have been well sealed and the retinas are stable and well attached. To confirm this you should have a consultation with your retinal specialist prior to your cataract surgery who can then clear you for the cataract operation. Once these precautions have been taken, it is likely that with an experienced Cataract Surgeon performing your procedure you will have a safe and predictable outcome.

Secondary Cataract Development Timing

Question: I have a question about the time to develop a secondary cataract. I am a 56 year old woman who had cataract surgery just 3 months ago in my left eye and 2 months ago in my right. My vision was perfect immediately after surgery--20/20 at distance and I could read without glasses pretty well. Now my close up vision is blurry and my intermediate vision in my left eye is also getting blurred. I am told this is due to a secondary cataract. Does this sound right? Do they happen this fast?

Answer: A secondary cataract, which is called posterior capsular opacification or “PCO”, is not an uncommon occurrence after cataract surgery and lens implants. In fact in some reports as many as 30% of patients having cataract surgery actually develop posterior capsular opacification. While the timeframe for the development of PCO can vary widely, it is possible for it to occur in patients a few months after their cataract removal. Depending on the density of the cataract removed, the difficulty of the actual procedure and many other factors can accelerate PCO formation. Fortunately, PCO is readily treatable with a YAG Laser Capsulotomy-a painless, quick and very effective laser treatment that produces almost instant improvement of vision.

Monday, November 26, 2012

Reading Glasses after Cataract Surgery

Question: I am 51 years old and have been advised that cataract surgery and a lens implant is needed in my left eye. I recently switched to multifocal contact lenses (-9.5 power) and am disappointed to have been told that I am not a candidate for a premium multifocal lens implant IOL and that I will need to wear reading glasses after the surgery. My doctor said this was due to the shape of my eye. Is there any hope of me consulting with another cataract surgeon and being told that cataract surgery can leave my free of needing reading glasses?

Answer: Your disappointment with not being a good candidate for a multifocal lens implant after cataract surgery to avoid having to wear reading glasses is understandable-especially in consideration of your adaptation to the multifocal contact lenses. It is not clear from your description what part of the “shape of your eye” is the issue-and you don’t state whether you are wearing rigid or soft lenses, so it is difficult to offer much more than some general comments. First, if you are a rigid gas permeable lens (RGP) lens wearer this could very well complicate the precision and accuracy of the measurements and calculations used for the lens implant. If you had induced astigmatism or other shape changes from the contact lens wear this could be a challenge. With less complex lens implants, the calculations are still subject to this variation, however with the multifocal lens implant the lack of precision will lead to a much greater level of dissatisfaction if it is present. You do not say if the shape of your cornea is otherwise normal or regular and thus one suspects that you might have a great deal or natural or induced astigmatism-which also could make the successful implantation of a multifocal lens implant more of a challenge as the astigmatism would ten need to be corrected after the cataract surgery either with a Limbal Relaxing Incision (LRI) or LASIK surgery in order to obtain full functioning and vision correction. If there is any doubt in your mind it is never inappropriate to get a second opinion. Find the best Cataract Surgeon in your area who is also a LASIK Surgeon and schedule a consultation. By finding a Refractive Cataract Surgeon you will avail yourself of the best information regarding your complex optical situation along with the need for cataract surgery.

Tuesday, November 13, 2012

Starburst after Cataract Surgery

Question: I had cataract surgery one month ago and had a toric lens implant. Immediately after surgery I have experienced a horizontal star burst with 4-6 long flares/rays at night while driving with oncoming headlights. Halogen and LED lights produce the most vivid star bursts. My cataract surgeon thinks this may be caused by a wrinkle or crease in the back of the capsule. He suggests a laser procedure to remove a section of the capsule to eliminate the crease. This sounds reasonable to me. What are your thoughts?

Answer: The type of visual symptoms that you are describing are very possibly due to a crease or wrinkle in the posterior lens capsule that is left in place in order to support the lens implant. This does happen from time to time and is immediately alleviated with a YAG Laser Capsulotomy which should in short order eliminate the starburst if this was the cause. While it is possible that there are other causes this is a logical place to begin and you should follow the direction of your Cataract Surgeon.

Multifocal Lens Implant for Artist

Question: I have poor distance vision and am due for cataract surgery shortly. An artist by profession I need good all round vision. However I have not coped well with multifocal spectacles and wonder whether the Lentis Mplus Multifocal Lens Implant that I have been offered may not suit me. I do not wish to experience alterations in my color vision or my area of vision to be restricted. I already suffer with glare and halos and poor night vision and was hoping that cataract surgery would get rid of this. Would I be better off choosing a standard lens implant and using glasses for close up work? What would my mid-distance vision be like?

Answer: As an artist you certainly have more demanding vision requirements than the average person, thus your caution and concern in choosing a lens implant after cataract surgery is well founded. That said, multifocal lens implants are very complex optical systems and ALL multifocal lens implants have optical limitations which do present some compromise to vision quality depending on their specific design. For this reason you should strongly consider having the lens implant with the BEST possible optics even though it may require that you wear eyeglasses for near or intermediate vision. This will likely be an aspheric wavefront optimized design that minimizes or eliminates aberrations including spherical aberration and chromatic aberration. Please discuss this with your cataract surgeon who can assist in the choice of lens implant and help you determine the working distances that will require eyeglasses.

Toric Lens Implant for Astigmatism

Question: Does the toric lens implant for cataract surgery totally remove astigmatism?

Answer: Toric lens implants for astigmatism correction after cataract surgery “correct” but do not “remove” astigmatism. If the astigmatism is regular and caused by the shape of the cornea being unequal in curvatures, toric lens implants are quite effective at correcting the vision if they are measured properly and implanted correctly.

Floaters after Cataract Surgery

Question: I had cataract surgery in October with an AcrySof® IQ Lens Implant. I told my cataract surgeon that I was seeing floaters ever since the eye surgery. The floaters seem to be getting worse. What should I do?

Answer: Floaters after cataract surgery and lens implants are not uncommon. In most cases the floaters are the result of changes in the vitreous gel inside the eye. This can be due to a vitreous condensation, liquefaction or detachment-called Posterior Vitreous Detachment (PVD). If the floaters are increasing or if you see distortion, bending or bowing or bubbling of your vision-especially if there are flashes of light, it would be important to return to your cataract Surgeon and have a thorough examination of the retina and the vitreous to be sure there is no traction, tears or detachment of the retina.

Multifocal Lens Implant Vision Problem

Question: My father had cataract surgery and multifocal lens implant about 18 months. He is 85 and active and is still having problems seeing with the lens implant that was used. He has symptoms that sound like a decentered or dislocated intraocular lens implant. The eye doctors at the facility had some problems inserting the lens implant at the time of surgery causing swelling to occur. They told him this would get better over time and that his vision would improve. Swelling went down but vision did not improve. He has returned for several visits and they tell him everything is fine, but his vision in the eye is still not correct.

Could there be a problem with the lens implant or some other issue that they are not discussing? I am planning to visit the doctor with him in the next 2 weeks and wanted to know if there were other questions I should ask or if there is anything that can be done to correct the problem. He can't drive at night and they have told him to get regular glasses to correct the vision problem.

Answer: Unfortunately it is impossible to know from your description the actual nature of the vision problem. Is it glare, halo, blur-at what distances-far, near, intermediate? You state he cannot drive at night-why? Glare-halo-blur? Or something else that might suggest a problem not with the lens implant itself but perhaps with the capsule left in place to support the lens implant. Was the cataract surgery itself complicated-was the capsule ruptured? You state there was “swelling”. Where was the swelling-the cornea or retina? As you can see there are MANY questions that need clarification through a clinical examination and then explained to you as the reason for your father’s difficulty with the multifocal lens implant. Or, it just may be possible that this is as good as his vision can be with the multifocal lens implant as, depending on the type of multifocal lens implant, they do often present a number of potential vision compromises which are exaggerated if the lens is not centered perfectly. That said, you certainly should be present and discuss the possibilities with the cataract surgeon after the next visit and exam. If the discussion does not give you a reasonable explanation and path to improvement-if possible-then find the best cataract surgeon in your area and schedule an appointment for a second opinion.

Wednesday, November 7, 2012

Monofocal Lens Implants for Near Vision

Question: Can I have a lens implant that is focused so that I have to wear eyeglasses to see clearly at distance but when I take them off I can see clearly to read? What is the distance that the reading capability kicks in and I'd have to remove my distance glasses? Would these lens implants reduce glare at night or halos around lights compared to multifocal lens implants?

Answer: The simple answer is yes you can have a monofocal or aspheric lens implant that is calculated in prescription strength so as to allow you to see clearly for near vision such as reading. This would then require that you wear eyeglasses to see at distance as you would be rendered “nearsighted” by the les implants. The distance that the near vision would be clearest would be a matter of you discussing this with the eye surgeon and determining the approximate distance at which you wanted it to “kick in” as this is a mathematical and optical calculation that is adjustable.

Wednesday, October 31, 2012

Monofocal Lens Implants with Contact Lens for Near Vision

Question: I currently use a contact lens in one eye to achieve simultaneous near and far vision. I am interested in having monofocal lens implants with my cataract surgery over which I would use a near vision contact lens to correct the deficit in near or far vision if I left the contact lens in all day. This is after all what I am used to now. I am fairly sure I want to avoid relying on having spectacles but could cope well with putting a contact lens in every morning. I thought that the implant with addition of a contact lens might therefore provide good all round “crispness.” I didn’t grasp whether this scenario was a possibility.

Answer: It is possible to have monofocal lens implants and use a contact lens to correct the near vision. This is possible but begs the question as to if you are happy with a monovision correction, why not have the monofocal lens implant calculated with the monovision correction in the lens implants. This would allow you to eliminate the need for the contact lens. Your best next step is certainly to discuss this option with your Cataract Surgeon and see if it might be appropriate.

Glare after Cataract Surgery, Toric Lens Implants, LRI & LASIK

Question: I had cataract surgery with a toric lens implant for astigmatism. I also had Limbal Relaxing Incisions (LRI) in both eyes and LASIK in the right eye. I have a great deal of glare in my vision in both eyes when I am in a bright light outdoors, indoors with lamps on or looking out a window. It is MORE than a starburst effect that I was told could be a side effect. This is relentless, morning noon & night. My astigmatism is improved & my vision tests better but learning to deal with this is as bad as trying to see around my cataracts. My doctors don't seem to want to address my problem. Am I going to have to live with this?

Answer: It is not possible to tell what the primary source of your glare is and how to remediate it without a considerable amount of additional clinical information. But, for sure the number of surgical procedures you have had is highly likely to have induced some very complex optical aberrations in the cornea-at a minimum. These optical aberrations are often compounded by the additional surgeries. It is not clear why you needed LASIK and LRI procedures after having a toric lens implant, however one would suspect that the optical outcome was not as targeted. If your Cataract Surgeon and other eye doctors are not willing or able to address the glare, it would be necessary to find the best Cataract Surgeon in your area who is also a LASIK Surgeon and possibly even a Cornea Specialist. Schedule a consultation and request that the aberrations in your eye be carefully evaluated by aberrometry, as well as the shape of your cornea by topographic imaging along with general results of the previous surgery so a possible solution can be offered.

Monday, October 22, 2012

Astigmatism Lens Implant Need

Question: Do I really need lens implants for astigmatism? My astigmatism is 1.00 D in the right eye and 1.5 D in the left eye. The cataract surgeon said both the basic lens implant would work but the toric lens implant will make things a bit sharper but costs $1,000 more for each eye. Will there be any noticeable difference with the toric lens implant?

Answer: Each cataract patient has a different tolerance to blur and defocus. However, depending on the direction and the orientation of the astigmatism it is possible that the defocus from the astigmatism will not only cause blurry vision but could also cause headaches and streaks of light at night as well as other distortions of light in dim or dark illumination. The astigmatism needs to be corrected. You can correct it by wearing eyeglasses after your cataract surgery, having a second surgery to correct astigmatism called Limbal Relaxing Incisions (LRI) or by having a toric lens implant at the time of cataract surgery-but the astigmatism should really be corrected in order for you to see your best and be most comfortable after the cataract operation.

Eye Bruises after Cataract Surgery

Question: I had cataract surgery on my right eye 5 weeks ago and the corner of my eye was darkly bruised after surgery. Now 5 weeks after the surgery the bruising in my right eye has lessened, but now I have dark areas in both corners of my eyes next to my nose. I checked pictures and this was not there before the cataract surgery. I am certain and I and my wife would have noticed it. I saw my doctor and he said it’s not from the surgery, but I am certain it is. Is there an explanation. It may seem a little trivial but I am a fairly young cataract patient- 40 and do not like the way this looks and also my operated right eyelid is a little droopy. Is there anything for me to do or will these things go away in time?

Answer: While it is impossible to tell or understand without a clinical examination, the types of bruises you are describing after cataract surgery as well as the time course do indeed make it difficult to really relate it to the a complication of the cataract surgery. The bruises and the droopy eyelid may be worth investigating by scheduling a consultation with an Oculoplastic Surgeon who is experienced in cataract surgery as well as the conditions, problems and structure and functioning of the eyelids and soft tissue around the eye and the orbital area. He or she should be able to provide and examination and consultation to help better understand what is happening here.

Thursday, October 11, 2012

Dry Eye Help for Cataract Surgery

Question: I have a severe dry eye and need cataract surgery. Is it possible to have cataract surgery and reduce the risk of ending up with even worse dry eye problems?

Answer: To have the most successful Cataract Surgery and avoid the risk of increasing your dry eye symptoms you should find a Cataract Surgeon who will aggressively treat your dry eye before the Cataract Surgery in preparation for a bit of a challenge to the integrity of your tears and tear film after the operation. Depending on the status of your tears and ocular surface, the aggressive preoperative treatment of your dry eye might include increased use of a carefully selected artificial tears, perhaps insertion of punctal plugs, prescription eye drops to help you make more tears such as Restasis® eye drops and nutritional supplements that might include certain types of Omega fatty acids or other vitamins. Cataract Surgery in and of itself can disturb the tear film and cause dry eye symptoms, so it would be important in the post operative period to continue the full course of dry eye treatment for a sufficient period of time or perhaps even permanently.

Tuesday, October 9, 2012

ReSTOR® Lens Implant Problem?

Question: I had cataract surgery and a ReSTOR® Lens Implant placed in my right eye 3 weeks ago and I have a problem. My vision is still blurry and I have a dull achy pain in my eye and temple area. When can I expect this to improve? I'm afraid to have my other eye done for fear that these symptoms will occur again.

Answer: One would typically expect you to be comfortable and see pretty well 3 weeks after a Cataract Surgery and Lens Implant operation. It would be important for you to schedule an appointment with your Cataract Surgeon so that he or she can evaluate the status of your surgery and determine the cause of the ache-which may or may not be related to the Cataract operation and/or the Lens Implant. If after having a follow-up examination with your Cataract Surgeon you are still dissatisfied with the explanation and outcome, then consider scheduling a second opinion consultation with the best Cataract Surgeon you can find in your area in order to get a resolution to the problem.

Thursday, October 4, 2012

Vision Problems after Cataract Surgery

Question: I had Cataract Surgery in July and I am having problems with my left eye which feels like my eye is constantly dilated and it's like I'm looking through a dirty lens. My Cataract Surgeon says everything looks okay and it's my brain playing tricks. It is driving me absolutely crazy. I have been back to my surgeon three times and he refuses to admit there is anything wrong. Please help what can I do?

Answer: Unfortunately there is no real way to tell why you are having the symptoms and vision problems you are experiencing without a thorough examination. Also, you do not indicate the type of Lens Implant that was used to correct your vision-which may be material to the problems. However, there are many other reasons including the possibility of posterior capsular opacification or even some irregularities in the posterior lens capsule that is typically left in place to support the Lens Implant. All of these items should be detected upon examination. Your best next step is to find the best Cataract Surgeon in your area and schedule an examination and consultation for a second opinion.

Dry Eye Pain after Cataract Surgery

Question: I had cataract surgery in my right eye one year ago. Problems began immediately, starting the day I left surgery with severe "stabbing" pains as if glass shards were cutting into the eye. This abated, only to be followed by severe pain that has persisted. It may be a form of dry eye caused by nerve damage during the surgery, and I can't help thinking something might have gone wrong with the surgery that I have not been told about. How can I find out a) whether the surgery had problems, and b) if it is dry eye, how to cope with it. I've tried Restasis and pretty much all the drops with no success.

Answer: As you do not seem to have confidence at this time in your primary Cataract Surgeon it might be worthwhile to arrange a consultation with another Cataract Surgeon for a second opinion in order to determine the actual diagnosis and reason for your pain. At this time you should consider finding a Cataract Surgeon who is also a Corneal Specialist and well versed in both Cataract Surgery complications as well as ocular surface disease such as dry eye.

Monday, October 1, 2012

Multifocal Lens Implant Choices

Question: The AcrySof® ReSTOR® Multifocal Lens Implant has been recommended to my husband who is in need of cataract surgery. He received little information from the cataract surgeon about this lens other than he only offered the ReSTOR® Multifocal Lens Implant or the basic replacement lens implant. After doing some research we think the ReSTOR® might be the best choice but we are concerned about the reports of halo or glare experienced during night vision since he drives often at night. I don’t know that all the all the information we have found is very current so we are wondering if the halo/glare is still an issue with this particular lens? He is interested in not having to wear glasses but being able to drive at night is a must.

Answer: All Multifocal Lens Implants are complex optical designs that utilize various types of refractive, diffractive or combination optics to achieve their effect. These optical designs ALL can cause some degree of glare and halo-or night photic disturbances. Further these night vision problems can actually be exacerbated without exquisitely precise surgical technique and implantation as their centration and positioning is critical. Also, some designs can cause a greater or lesser amount of night vision disturbance depending on pupil size. That said, in general the AcrySof® ReSTOR® Multifocal Lens Implant tends to cause a lesser degree of night vision problems when optimally implanted in patients with appropriately sized pupils-BUT still all patients should be aware of the possibility of night vision problems. As you are raising a valid question and concern it might be wise to seek a second opinion by finding the best cataract surgeon in your area who uses multiple multifocal and accommodating near vision lens implant technology platforms in order to have the best and most broad based evaluation.

Cataract Surgery Variable Vision

Question: I had cataract surgery almost 1 month ago but have variable vision so that my far vision is sharp in the morning but turns blurry within a couple of hours. I can see well up close but I wanted the far vision to be clear. Is there a way to tell if the wrong lens implant were used? If so can the lens implant be taken out and others put in their place?

Answer: There is no way to tell why your vision is variable throughout the day as this is not typical after cataract surgery and lens implants. You certainly should discuss this with your cataract surgeon. It is not likely that an incorrect lens implant power would create this kind of variable vision, however if once your vision was stable there was in fact a need to adjust the implant strength, as long as your eye were healthy overall it should be possible to have a lens exchange at the direction of your cataract surgeon.

Time to Remove Cataracts

Question: I have cataracts in both eyes and my eye doctor said they can’t be removed until about 2 years from now. My right eye is worse than the left and although my eyes have always been sensitive the cataracts really bother me now. I want to know why I have a cousin that is 10 years younger than me and he was able to have his cataracts removed.

Answer: The time to remove cataracts is when they are bothersome enough so as to cause you sufficient visual discomfort, inconvenience or limit your mobility and safety in your daily activities. This usually means that there is noticeable blurry, cloudy or fuzzy vision with or without glare or light sensitivity. While many insurances and Medicare have certain thresholds of vision loss and symptoms that must be met in order for them to pay for cataract surgery and lens implants, it is pretty typical to have met these standards if you are manifesting the degree of symptoms described. In the distant past it was necessary for cataracts to be “ripe” before they could be removed. That is simply not the case today with modern cataract surgery techniques. If you are not satisfied with the opinion of your eye doctor it would be a good idea to consider scheduling an appointment for an examination and consultation with the best cataract surgeon you can find in your area and see what they recommend.

Monday, September 24, 2012

Toric Lens Implant or LRI for Astigmatism

Question: I have cataracts and astigmatism and have seen two cataract surgeons. One recommended LRI and one recommended toric lens implants with cataract surgery. Which is better to do?

Answer: Both Toric Lens Implants and Limbal Relaxing Incisions (LRI) can be used to correct astigmatism with Cataract Surgery. Depending on the amount of astigmatism, the health of the cornea, the quality and quantity of the tear film and a few other factors, there may be a preference in the hands of some Cataract Surgeons. The predictability, stability and precision of Toric Lens Implants is generally considered to be better by most eye surgeons.

Thursday, September 20, 2012

Toric Lens Implant Option

Question: I had cataract surgery and a lens implant on my right eye. The cataract surgeon dilated my eyes before surgery and I do have a astigmatism. Shouldn't I have had the toric lens implant?

Answer: The decision and necessity of having a Toric Lens Implant with Cataract Surgery really depends on more than simply having astigmatism. The appropriateness depends on the amount and direction of astigmatism in the prescription itself, the amount and direction of the astigmatism created by the shape of the cornea as well as the location of the surgical incision to be made for the Cataract Surgery itself. That said, if it were necessary to have a Toric Lens Implant it is highly likely that your cataract Surgeon would have suggested this option.