Tuesday, January 31, 2012

Cataract Surgery Success & Dry Eye

“We take a success optimizing approach toward our cataract surgery consultations-and that often includes careful diagnosis and treatment of dry eyes and eye surface problems even before the actual surgery”, commented San Antonio Cornea & Cataract Surgeon Lisa Martén, M.D. of the South Texas Eye Institute. “Many cataract patients may not even realize the need for help with dry eye problems in order to get the most comfortable and quickest visual recovery after cataract surgery.”

“Really taking care to make sure that we have evaluated the quality and quantity of tears along with the health of the ocular surface and eyelid margins is essential in helping get patients the best results after cataract surgery'” noted Leslie Doctor, M.D., a Connecticut Cataract Surgeon & Cornea Specialist at Doctor & Associates with offices serving Fairfield County in Westport, Wilton and Norwalk. “This is particularly important for our patients who are having astigmatism correcting toric lens implants and near vision presbyopia correcting lens implants where the expectations of having really good vision after cataract surgery are pretty high.”

“Our San Antonio cataract patients are often quite challenged by the environmental dust and dryness we have in San Antonio,” stated Dr. Martén. “Fortunately, today we have a number of effective options to help our cataract patients with dry eyes and can get them to successful outcomes,” she noted.

Houston cataract surgery patients experience the same sorts of ocular surface and dry eye challenges as well-the environment in combination with aging effects and even some of the side effects of the systemic medications they are taking mean that we just have to look a little more carefully and work a little harder to be sure we do whatever is necessary to get our Houston cataract patients the best overall results,” stated Galveston and Houston Cataract Surgeon Bernard Milstein, M.D. of The Eye Clinic of Texas.

Monday, January 30, 2012

Floaters after Cataract Surgery

Question: I have a question about floaters and cataract surgery. I had cataract surgery on 12/13/11 for cataract removal and was told a membrane type material had formed and covered the lens making my vision poor. He referred me to another eye surgeon who performed a second procedure to deal with the problem. My vision after the second surgery has improved however I experienced considerable floaters. The floaters have decreased in volume for the most part to thin hair like floaters but can I expect the floaters to further decrease in size and volume?

Answer: From your description is not obvious whether you had a ruptured posterior capsule that required a vitrectomy by the second surgeon or simply an immediate posterior capsular opacification requiring a YAG Laser Capsulotomy to clear the vision. If you had a vitrectomy it is quite common to experience floaters after the procedure and sometimes for a few months before they fully settle down.

If you had a YAG Laser Capsulotomy this can also sometimes be accompanied by some post procedure floaters that also can persist for a short period of time. In any event, you should discuss the floaters with the second eye surgeon who will be able to give you some sense oh how long they might persist based on the type of procedure you had and the extent of the procedure.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery Monovision & Crossed Dominance

Question: I have a question about Monovision cataract surgery. I had cataracts in both eyes and, together with my cataract surgeon, decided to operate on the eye with the more advanced cataract first. So we scheduled surgery to put in a monofocal IOL. The night before the surgery, I spoke with my brother, who'd had cataract surgery for one eye a few years ago. He told me about Monovision and the possibility of not needing reading glasses. This was the first I'd heard of this option.


The next morning, before the surgery, I brought this up with my surgeon. He suggested that we go ahead and do the prepped eye and discuss Monovision after the surgery. So we did.

Afterwards, I learned that it's customary to put the distance lens in the dominant eye. Furthermore, from my medical records I learned that the eye with the monofocal IOL was NOT my dominant eye. So, if I decided on Monovision now, the arrangement would not be optimal.

To evaluate my options, over the past three months I have been wearing contact lenses in the eye that still has a cataract. (The cataract is much less advanced, so my vision in the eye is good.) One lens corrects for distance, and the other gives me Monovision. I have had no trouble with Monovision, other than mildly less sharp distance vision. And, I have decided I like Monovision better than the alternative of both eyes having distance implants and using reading glasses for close-up and computer work (which I do a great deal). So now I want to plan the surgery for the other eye.

In light of the fact that the distance lens is already in my non-dominant eye, what things should I take into consideration now? Is there anything I can do to adjust for the fact that the monofocal lenses will be "backwards" from the usual Monovision arrangement? Or, am I being overly concerned, with the difference between having the distance lens in the dominant eye vs in the non-dominant eye having inconsequential implications?

Answer: Monovision Cataract Surgery is becoming more and more popular as patients become aware that they can have the option of being "glasses free" for the vast majority, if not all activities, after a Cataract operation. Monovision vision correction has been used for almost 50 years in contact lens vision correction and then for almost 20 years with Laser Vision Correction. So the concept of modifying the optical correction so that one eye is fully corrected for distance and one eye is corrected for a mild near correction is not at all new-and it has in fact been researched and studied for may years regarding success factors and patient acceptance. The "gold standard" for predicting patient success with Monovision of any type of optical correction is estimating the patient's "tolerance to defocus".

You are correct that typically the dominant eye is corrected for distance vision and the non-dominant eye is corrected for near. This is based on the research that demonstrates that +/-50% of patients have a better tolerance to defocus when the dominant eye is corrected for distance, 20-30% have the same acceptable tolerance regardless of which eye is corrected for far or near and 20-30% cannot tolerate defocus whatsoever. The patient response is thought to be based on the "strength of dominance" which is a learned neurological pattern. Thus, for almost 1/3 of patients it makes no difference which eye is corrected for far or near-they do well.

NOW-the important thing to know is that the best predictor of "tolerance to defocus" is a trial with contact lenses-exactly as you have done. If you are comfortable with your vision over a 3 month period of Monovision correction with a "crossed dominance", then there is every reason to predict that you will do well with you Monovision Cataract Surgery as long as the amount of attempted correction difference between the two eyes approximates what you have been wearing. The only additional consideration that you might wish to discuss with your Cataract Surgeon is if in fact you have had a basic spherical monofocal lens implant, the possibility of using a monofocal aspheric lens implant for the near vision corrected eye. IF-BIG IF-the Cataract Surgeon measures the aberrations in your eye and finds them to be of a particular type and magnitude, it is sometimes possible to select an aspheric lens implant that actually enhances the optical depth of focus and adds a little additional "range" to the Monovision correction. Your cataract Surgeon may already be doing this as a matter of course or in fact they may find that it would be counter productive to use this type of Lens Implant based on the measurements and calculations. It might be worth inquiring.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, January 27, 2012

Cataract Surgery & Astigmatism Correction

Question: I had the cataract removed from my right eye and have 20/20 vision in the right eye. My left eye does not have a cataract but has astigmatism requiring -4 prescription. Does it make sense to consider removing the lens in my left eye to achieve 20/20 vision in both eyes.


Answer: While you state that you do not have a Cataract in your left eye, depending on your age you may develop one in the foreseeable future as the presence of Cataracts is quite common as we age. As your right eye Cataract Surgery and lens implant was so successful as to provide you with 20/20 vision, it is unfortunate that unless you do something to the astigmatism in the left eye you will need to wear eyeglasses to see clearly with that eye. It would certainly be convenient and hassle free not to be dependent on glasses for seeing at distance. There are really two options that you might wish to consider to be independent of glasses for seeing at a distance.

First, if there is ABSOLUTELY no evidence of a Cataract even beginning to form, and your eye and tear film are otherwise healthy, you could consider LASIK to correct the astigmatism in the left eye. Second, more and more people are indeed opting to have vision correction with lens implants-in your case using an astigmatism correcting toric lens implant-with a lens removal would also give you another option for vision correction AND would thus eliminate the need to ever be concerned with or have the need for a Cataract Surgery in the left eye as there would be no natural lens to cloud. This is something you should review with your Cataract Surgeon as it might make good sense.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, January 26, 2012

Cataract Lens Implants & Vision

Aspheric lens Implants can give excellent vision after cataract surgery as they can be designed to improve image quality by minimizing spherical aberration. “We know that as we age and the crystalline lens of the eye starts to progress toward the formation of a cataract, there is an increase in the overall spherical aberration of the eye which is important to neutralize with aspheric lens implants after cataract surgery,” commented NJ Cataract and Corneal Specialist Joel Confino, M.D. of The Eye Care &  Surgery Center in Westfield. “Aspheric lens implants for cataract surgery have pretty much become routine for almost all of our patients.”


Leslie Doctor, M.D., a Corneal Specialist and Connecticut Cataract Surgeon remarked, “Hearing cataract patient feedback about the sharpness of their vision-especially in dim lighting conditions or driving at dusk-really motivates me to use aspheric lens implants of some type for all of my cataract surgery patients. Recent studies on aspheric lens implants support what patients tell us. It is probably not just Norwalk and Fairfield County cataract patients, but all patients today are really quite knowledgeable and want the best possible vision.”

“We have been studying optical aberrations in cataract patients for some time,” stated Marc Michelson, M.D. of Alabama Eye & Cataract Center in Birmingham. “We too use aspheric lens implants as a matter of course for our cataract patients. They just give our patients a higher quality of vision after their cataract surgery. Cataract surgery techniques are quite advanced-now with the more sophisticated lens implant designs we have available we can continue to help patients get better and better vision after their cataracts are removed.”

Lens Implant for One Cataract

Question: Can I have an IOL lens implant in one eye, since I have a cataract just in one eye?


Answer: While it is possible to have a Cataract removed and a Lens Implant in one eye with good results, in some cases it may not be the simplest optical alternative. If you wear eyeglasses to see at distance and thus require optical correction for both eyes, it will be necessary for the Cataract Surgeon to calculate a Lens Implant power that creates a refractive error that leaves you with the same approximate prescription requirement as the non operated eye so that you can continue to comfortably wear eyeglasses for distance. Too much of a difference between the eyes makes wearing eyeglasses after Cataract Surgery difficult and could require a contact lens for the unoperated eye. That said, it is perfectly fine to have an IOL in one eye as long as you discuss the optical correction needs 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 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.

Tuesday, January 24, 2012

Haloes after Cataract Surgery & Lens Implants

Question: Will the halos after cataract surgery and lens implants go away?


Answer: You do not state the length of time the length it has been since your Cataract Surgery and Lens Implants nor do you identify the type of Lens Implant that was used to correct your vision thus it is difficult to share too many specific thoughts. In general, some patients do experience halos after Cataract Surgery during the initial few weeks or months as they adapt to the new vision and optics of the Lens Implant. Some types of Lens Implants such as Multifocal Lens Implants for correcting far, near and arm's length vision are reported to cause more halo effect than others due to their design. Even with these lenses, over time the disturbance becomes minimal for most patients. There are instances when the posterior capsule of the crystalline lens becomes opacified, that patients may also complain of glare and haloes. Thus in these cases the halo may actually become worse over time. So, depending on how long it has been since your Cataract operation and what type of Lens Implant has been used, the answer could vary. The best thing to do is to bring the presence of haloes to the attention of your Cataract Surgeon so they can identify the cause and give you a specific answer.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgeons & Lens Implants-Role as Ophthalmic Consultants



“Refractive Cataract Surgeons serve as ophthalmic consultants for many patients seeking to not simply have their cataracts removed, but to do so with a result that essentially leaves them “glasses free”, commented Corneal Specialist, Refractive & Cataract Surgeon Leslie Doctor, M.D. who serves as an ophthalmic consultant in Connecticut for Fairfield County patients.


“Toric lens implants for cataract surgery help us get patients to their goal of seeing at a distance without glasses after a cataract is removed,” added New Jersey Corneal Specialist, Refractive & Cataract Surgeon Joel Confino, M.D. of The Eye Care & Surgery Center. “And since astigmatism occurs in about one in three people and may occur in combination with nearsightedness or farsightedness, being ophthalmic consultants is as much a part of what we do as being cataract surgeons. Toric lens implants are a frequent topic of discussion with our patients.”

“Modern cataract surgery is quite sophisticated and technically demanding,” stated Ravi Shah, M.D., Corneal Specialist, Refractive & Cataract Surgeon at Eyecare Medical Group in Portland, Maine. “Now that we are using many more advanced technology implants such as toric lens implants for astigmatism, we have all found the need to expand our role as ophthalmic consultants to help patients get a better understanding of what these implants can and cannot do-setting and shaping expectations as we do for LASIK patients is as much a factor in patient satisfaction as surgical excellence.”

If you wish to learn more or would like to schedule a consultation about cataracts, cataract surgery and vision correction with toric lens implants, you may contact Leslie Doctor, M.D. at the Doctor & Associates offices in Westport, Norwalk or Wilton, Connecticut by calling 203-227-4113. Joel Confino, M.D. can be reached at The Eye Care & Surgery Center offices in Westfield, Warren or Iselin, New Jersey by calling 908-789-8999 and you may reach Ravi Shah, M.D. at Eyecare Medical Group in Portland, Maine at 888-374-2020.

Monday, January 23, 2012

Toric Lens Implant Price

Question: I had cataract surgery and paid an extra $1200 per eye for toric lens implants to be put in. Was that a good price?


Answer: Patients having Cataract Surgery with advanced technology Lens Implants such as Toric Lens Implants to correct astigmatism need to understand and need to realize that what they are paying for in the incremental charges for these types of Lens Implants is NOT simply the cost of the Lens, but the significant amount of time and testing necessary to test, measure and calculate the best possible Lens Implant prescription and type to get the best possible results. This may require additional or supplemental biometry or eye length measurement, corneal curvature measure with one or more instrumental methods including corneal topography, in many cases aberrometry and further a careful and thorough analysis of tear film quality and quantity as this can have a meaningful impact on the visual outcome.

This testing requires staff, time and instruments-this costs money-above and beyond the cost of the Lens Implant itself and is often not a covered service by Medicare or insurance companies. To determine whether you got a "good price" ask yourself the question-"Can I see with good clarity at distance so I no longer am dependent on glasses?" If the answer is yes then you probably got a "good price" as you received the outcome you desired and thus "good value for money paid".

You are not alone in this question as many patients believe it is within their purview to "shop" for Lens Implants and seek the best price rather than targeting their efforts on getting the best results. This is a huge error in judgement. If you needed a heart valve replaced and the Cardiac Surgeon indicated that he or she could use the valve the insurance company provided and it would cost you nothing-BUT it would only allow you to do most things, but it wouldn't fully correct your heart defect. Or, you could pay $2,000 for an advanced technology heart valve that would give you cardiac function equal to a 25 year old...would you shop for the "best price on a heart valve". There is a growing and serious problem with patients "shopping price" as they are not equipped to make effective decisions regarding selection of medical devices used as surgical implants or otherwise.

This is NOT like buying a car or television where you can have buyers remorse and return it if you make an error or don't like the way it performs. Patients would be best served to find the best Cataract Surgeons who are trusted Cataract Surgeons and let them guide the most appropriate decisions in getting the best possible results. Rest assured that there is no free lunch and certainly no bargains in quality health care of any type-cataract surgery, heart surgery, brain surgery, orthopedic surgery or any other surgery that uses implantable medical devices.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Sunday, January 22, 2012

Sex after Cataract Surgery

Question: I would like to know how long to wait to have sex after cataract surgery. I had cataract surgery on my left eye 4 days ago and it is healing nicely and my vision has improved. I'm using eye drops-both antibiotic and anti inflammatory. I will be taking the anti inflammatory drops for 3 more weeks and the antibiotic drops for 3 more days. My right eye was done 3 months ago and is fine. How soon after my left eye surgery would it be safe to have sex?


Answer: In order to be pretty cautious in your return to daily activities, sex after Cataract Surgery might fall into the group of vigorous or strenuous activities. In general, most Cataract Surgeons recommend that the return to full daily activities-including vigorous or strenuous activities-be commenced when you have finished using all of the prescribed eye drops. This might be a conservative approach and the precise answer should come directly from your Cataract Surgeon as well as your previous experience with the Cataract operation on the right 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 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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Dizziness after Cataract Surgery

Question: My husband had cataract surgery on his right eye about four weeks ago and now complains of light-headedness and disorientation especially in crowds. He says the sight of people moving around makes him dizzy and he cannot look at a TV or computer screen for more than a few minutes. He wears glasses and removed the lens from the right eye of the glasses in hopes that would help but it has not. Is this a common occurrence?


Answer: The dizziness he is experiencing after his Cataract Surgery could be due to many things. Some may be related to the Cataract operation and vision and some may not. A possible cause that has to do with your husbands eyes is related to the difference in prescriptions between the two eyes after Cataract Surgery. The right eye seems to no longer need eyeglasses to see at distance but still will need help with glasses for arm's length (computer) and near vision. The unoperated left eye still has an eyeglass lens for distance and near. Thus there may very well be a considerable difference in the optical focusing between the two eyes as well as the image sizes between the two eyes. This can often happen in between the time one eye has had Cataract Surgery and the other eye is waiting to be done. Usually with Lens Implants of the proper prescription in both eyes after Cataract Surgery the dizziness and disorientation cease. However, you should certainly be sure that there are no other systemic or other health reasons for the dizziness and should consult your primary care physician.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery & Fuch's Dystrophy

Question: My husband had failed cataract surgery due to his taking Flomax and having Fuch's corneal dystrophy. He now needs to have cataract surgery again, together with a cornea transplant. I would appreciate some comment on whether he should have both cataract surgery and cornea transplant done at the same time?


Answer: It is not obvious in what timeframe your husband had the previous Cataract Surgery in which there was an unsuccessful result due to Flomax and the presumed complications of Cataract Surgery this medication causes as well as having Fuch's Dystrophy. For the most part, today knowing in advance that a patient is or has been taking Flomax allows the Cataract Surgeon to plan and make adjustments to the surgical plan that typically reduce the chances of complications. In addition, for many patients with Fuch's Dystrophy a less invasive type of corneal transplant called Decemet's Stripping Endothelial Keratoplasty ( DSEK) can be a good option with a shortened recover time and an excellent visual outcome. There are many Corneal Specialists who are Cataract Surgeons who perform these combined procedures as a matter of course. While a combined procedure is the likely best path, whether to proceed with a combined procedure is really a decision for the Corneal & Cataract Surgeon as it can depend on the stage of the Fuch's Dystrophy as well as the stage of the Cataract formation. You should really follow the advice of your doctor and if you are uncomfortable it is always appropropriate to seek a second opinion.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, January 16, 2012

Stroke after Cataract Surgery

Question: My father aged 75, just had cataract surgery on both eyes. His right eye was having issues, something pressure being high? A week later he is in the hospital with what they think is a stroke. Can eye surgery cause a stroke?


Answer: Eye surgery, including Cataract Surgery, can sometimes cause an elevated pressure inside the eye-intraocular pressure-which can cause a retinal vascular occlusion if the pressure is not controlled. However, high pressure in the eye or eye surgery itself would not likely cause a stroke. More likely, the underlying cause will be related to some other systemic health or vascular problem.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, January 12, 2012

Advances in Cataract Surgery Recovery

Fairfield County Cataract Surgeon Leslie Doctor, M.D. commented on advances in recovery from cataract surgery. “Even though cataract surgery can be a life changing event for patients who have regained their ability to drive safely-especially at night, or enjoy reading again after their cataract is removed-the fact remains that virtually all patients are concerned about their recovery from cataract surgery.”

Dr. Leslie Doctor offers a perspective on the advances in cataract surgery. “Today cataract surgery uses a combination of technology and technique to deliver what we call a “small incision-no needle-no stitch” surgery procedure that is “minimally invasive” so that it delivers a comfortable experience and quick visual recovery for the vast majority of patients. By using a microscopic ultrasonic probe, gently inserted through a 2-3 millimeter incision to liquefy and aspirate the cataract there is a greater margin of safety and faster healing for patients. These tiny incisions are self-sealing so that stitches are usually not required-and this reduces the risk of bleeding, scarring, and irritation and allows a more rapid return to normal activities and good vision. Further, the advanced technology foldable intraocular lens implants (IOL) that we use to correct vision are made of soft, flexible materials and can actually be inserted through these 2-3 millimeter incisions. Probably what makes patients most comfortable is that this combination of techniques and technology allow most of my cataract operations to be performed using topical eye drop anesthesia, eliminating the need for injections around the eye so that patients are pretty much able to use their eyes immediately after surgery and it minimizes the need for patching the eye after surgery.”

“As Norwalk eye surgeons some 40 years ago, my mother and father would discuss performing cataract surgery at Norwalk Hospital where patients needed to stay for a few days after cataract removal and in fact were required to lay still for the eye to heal. There was often discomfort and local anesthesia with needles was the norm. Everyone got stitches that could be uncomfortable for patients,” said Dr. Leslie Doctor.”What a world of difference from what we can do for patients today to make their cataract surgery recovery quick and comfortable.”

Leslie Doctor, M.D. is a Corneal Specialist, Refractive and Cataract Surgeon in Fairfield County, Connecticut where she is Medical Director of Doctor & Associates with offices in Norwalk, Westport and Wilton as well as a Clinical Assistant Professor of Ophthalmology at the Yale University School of Medicine in New Haven Connecticut where she teaches advanced techniques of Cataract Surgery & Intraocular Lens Implantation (IOL) to new eye surgeons in Connecticut.

Doctor & Associates serves as ophthalmic consultants for Connecticut patients seeking information, examination and counsel for cataracts, cataract surgery and lens implants, and may be contacted by calling 203-227-4113, or visiting http://www.doctor-and-associates.com/ or facebook.com/doctorandassociates.

Repeat Cataract Surgery

Question: My husband had cataract surgery about 20 years ago and lens implant put in. Does the procedure ever have to be redone ?


Answer: A Cataract is clouding of the crystalline lens inside the eye. During a Cataract operation procedure the cloudy lens material is permanently removed and does not regrow. Lens Implants are permanent and last a lifetime barring any other eye disease, trauma or infection. What can happen is that the posterior lens capsule that is left in place to support the Lens Implant can become cloudy over time and requires a brief YAG Laser Capsulotomy to create a clear opening. Usually this occurs in shorter timeframe than 20 years after Cataract Surgery. So, as long as your husband is enjoying good vision he should continue to have regular eye exams for glaucoma, macular degeneration and any other eye diseases, conditions or problems that can adversely impact eye health and vision and not be concerned with having to repeat his Cataract Surgery and Lens Implant procedure.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Haloes after Cataract Surgery

Question: Is it normal to experience large halo effect around objects after cataract surgery?


Answer: Your question about haloes after Cataract Surgery is difficult to answer as we do not have some important information including how long ago your Cataract operation was performed and what type of Lens Implant was used. While one would not necessarily call it "normal", it is entirely possible to have haloes after Cataract Surgery that vary in cause depending on how long after the Cataract was removed they occur. Haloes in the short term can be due to some corneal edema or swelling. In the longer term haloes after Cataract Surgery can be due to posterior capsular opacification among other reasons. It is a common side effect of certain near vision correcting multifocal implants to also cause the potential haloes you describe based on their optical designs. All of these reasons aside, haloes after Cataract Surgery are almost always temporary and should not persist. If they are excessively annoying or are lasting for any length of time you should discuss this with your Cataract Surgeon who can give you a specific cause and remediation as needed.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Lens Implants for Vision Correction

Question: I am a healthy male age 44 and am experiencing near vision problems. Can I go ahead and elect to have a Crystalens® that will alleviate this problem now? I do not have cataracts or any other vision problem.


Answer: Lens Implants for Vision Correction are being used more and more frequently for patients in their late 40's and 50's who are dependent on eyeglasses or contact lenses for seeing clearly at distance and up close. The fact that you state that you have no other vision problem other than your near vision focusing problem-called presbyopia-may not make you an ideal candidate for Lens Implants for Vision Correction such as the Crystalens® Accommodating Lens Implant, the AcrySof® ReSTOR® Multifocal Lens Implant or the Tecnis® Multifocal Lens Implant.The only way to really find out is to find an eye surgeon who is both a top Cataract Surgeon but also a Refractive Surgeon and schedule a consultation.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Eyelid Blepharitis & Cataract Surgery

Question: My wife had cataract surgery on both eyes in June 2011. To this day her eyes water, burn, pinch and get red. She had follow appointments and complained about this problem and her cataract surgeon said that skin flakes from her eyelids caused this problem. She washed and cleaned her eyelids many, many times but no improvement. Would it be wise to get a second opinion? Could this be a possible side affect? Please advise.


Answer: The description of your wife's eyelid problems and discomfort suggest that it is possible that she has some type of blepharitis or eyelid inflammation that may be contributing to her complaints. This is not really a side effect of Cataract Surgery and is most likely completely unrelated. However, if this is the problem, either her Cataract Surgeon or another eye surgeon should be able to carefully diagnose the cause and provide some form effective therapy which might include a number of options in addition to simply washing the eyelids. It is never inappropriate to get a second opinion if you are uncomfortable. In this situation it might be worthwhile seeking a consultation with an eye doctor who is a Corneal Specialist also trained in External Diseases.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, January 10, 2012

Far Vision & Multifocal Lens Implants

Question: I am considering cataract surgery and using a multifocal lens implant to correct my near vision. Will I be able to wear my contact lens after surgery to improve my far vision as I do now?


Answer: With careful measurements, the use of a Multifocal Lens Implant for vision correction after Cataract Surgery should allow you to see far, near and arm's length without being dependent on eyeglass and contact lenses. That is, you should not need to wear contact lenses for seeing at distance once you have a Lens Implant after Cataract Surgery. The goal of using the Multifocal Lens Implant is to not necessitate the use of glasses or contacts after a Cataract is removed and thus while you would most likely be able to wear contacts, you should not have to.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

NJ Cataract Surgeon on Lens Implants

NJ Cataract Surgeon Joel Confino, M.D. of The Eye Care & Surgery Center with offices in Westfield, Warren and Iselin, New Jersey commented on the growth and acceptance of advanced technology lens implants for vision correction after cataract surgery. “As a cataract and refractive surgeon I have typically spent a good part of each day counseling patients on options for vision correction that would help them become less dependent or even independent of glasses. We are beginning to experience a second surge in patients wanting to be free of glasses. It used to be primarily patients in their 20’s, 30’s and 40’s wanting LASIK-today it is driven by the 78 million baby boomers in America who are now turning 65 years old at the rate of 10,000 per day, and they are interested in choosing lens implants that will give them the lifestyle quality they want–free of glasses.”

A growing number of cataract surgery patients can now choose to enhance their spectacle-free vision through the implantation of astigmatism correcting toric lens implants (IOL) or even an accommodating or multifocal lens implant (IOL), which can help patients reduce dependence on glasses for clarity at far, intermediate and near. It is estimated that by the year 2020, 60-70% of cataract surgery procedures will incorporate the use of a toric lens implant or multifocal lens implant for vision correction.

To schedule an appointment or for more information about cataracts, cataract surgery or lens implants you may contact New Jersey Cataract Surgeon Joel Confino, M.D. at The Eye Care & Surgery Center by calling 908-789-8999, or by visiting http://www.newjerseyvision.com/ or facebook.com/eyecareandsurgerycenter.

Discomfort & Symptoms after Cataract Surgery

Question: I am 50 years old and had cataract surgery and lens implants in both eyes-the first eye in mid-November and the second eye in mid-December. I was very nearsighted before the cataracts were removed and wore gas permeable contact lenses and glasses on top to read. My cataract operation was done so that I have a slight Monovision with my left eye slightly near sighted to be more for close up, but I still have to wear readers, and the right eye is set for distance. I can see okay but my eyes constantly feel tired and ache and feel scratchy like they used to when I wore contacts and needed to take them out and put my glasses on to give my eyes a rest. Is this typical and does it go away? I am using steroid eye drops and artificial tear drops which don't seem to make any difference. Why do my eyes feel like this if I can see okay?


Answer: While it is impossible to know exactly what you are experiencing without an examination, there are some possible reasons that may be considered.

The symptoms that you describe of eye fatigue, aching and especially scratchiness are typically associated with problems of the surface of the eye and/or the tear film itself or both. Dry eyes after Cataract Surgery is a relatively common finding itself. Further, long term wear of rigid gas permeable contact lenses does temporarily cause some changes to the eye surface and its ability to retain a stable tear film. Additionally some of the drops that you are using may also have preservatives that could cause instability of the tear film and dry eye symptoms such as you describe.

Last, you age and any associated hormonal changes might further increase the chances that you have a dry eye and poor tear film. Any one of these factors alone or in combination might lead to the dry eye symptoms that you complain of. It might seem that the artificial tears should help, but this may or not be the case depending on the cause and whether those artificial tears have preservatives. Your best course of action is to fully discuss your symptoms with your Cataract Surgeon and ask for help in alleviating them. If they are in fact due to problems with the ocular surface an/or tear film itself there are a number of treatment options that might be recommended above and beyond artificial tear drops that could be prescribed by your Cataract Surgeon to help you with your symptoms.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, January 6, 2012

Cataract Surgery & Lens Implant Exchange

Question: I had cataract surgery and a lens implant in my left eye for arms length vision. It has not worked-I now have 3 pairs of glasses and am pretty miserable with dry eye. Is it possible to "do over" cataract surgery and have the lens implant changed so that it is the same as the one in my right eye?

Answer: Depending on how long ago you had the Cataract Surgery and Lens Implant in the left eye as well as the health and condition of the eye there is a good likelihood of a safe lens implant exchange that can allow for the vision to be "matched" to the right eye. This will really depend on the integrity of the structures in the front of the eye and the Vitreous Gel that supports the Retina in the back of the eye-but yes, in general a lens exchange is often possible. Dry Eye has been reported to occur in as many as 30% of patients after a Cataract is removed and with proper treatment should also be manageable. If you feel that you are not getting the proper treatment or results you may wish to consider finding the best Cataract Surgeon your area who is also a Corneal Specialist experienced in complex Cataract Surgery as well as problems with the eye's surface and tear film, and scheduling a consultation.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery for One Eye

Question: I am 70 and only my right eye has a cataract that needs to be removed and vision is bad in it. The left eye has really good vision with a cataract barely starting. Is it necessary to have the good eye done as most doctors recommend doing or wait until it gets bad. If I have the more expensive IOL put in the right eye, will it confuse the issue of seeing out of both? Do doctors ever put the multifocal lens in one eye and one just for distance in the other or would this confuse the issue of seeing out of both.


Answer: The decision on when to have a Cataract removed really depends on how much that Cataract disturbs both your vision and overall functioning. If you proceed in having Cataract Surgery with a Multifocal Lens Implant in the right eye, it is quite likely that the right eye will require no eyeglasses for far, near and arm's length vision. If the left eye does not have a similar functioning Lens Implant or doesn't have any Lens Implant it will probably decrease the overall effectiveness of the Multifocal Lens Implant in the right eye-and it will require eyeglasses to see intermediate and near distance-which means you will still need to wear glasses. Further, the effectiveness and success of Multifocal Lens Implants is generally better when BOTH eyes have the same type of Lens Implant. Your best course of action is to follow the advice of your Cataract Surgeon and if there is any question about what to do, schedule a consultation with another Cataract Surgeon for a second opinion. This is always a prudent path if there is uncertainty in your mind.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, January 2, 2012

Monovision Lens Implant Success

Question: What is the percentage of satisfied patients receiving monovision correction for cataract lens replacement?


Answer: Monovision correction has been used in contact lens vision correction, LASIK Eye Surgery as well as Lens Implants for vision correction with and without Cataracts for quite some time. Monovision outcomes are best when care is taken to pretest and measure as much as possible in order to determine the patient's tolerance to slight blur as well their tolerance to the range of defocus that will be established by the Monovision correction. With careful patient selection and a need for no more than 1.50 D to perhaps 1.75 D of near correction, the patient success for Monovision of any type is in the 75% range.

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 surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.