Cataract Surgery and IOLs

Cataract Surgery and IOLs

Cataract surgery is an effective and safe procedure to replace the inner lens of the eye which has become cloudy with an artificial lens that will enable the person to see clearly again.

Cataract is a common eye condition that occurs due to various reasons, but the main cause is age. The older a person gets the more cloudy the lens inside their eye becomes which can lead to a milky white color of the lens. The less transparent the lens becomes, the more it causes impaired vision and sometimes glare from looking at lights. The good news is that there is very effective treatment for this condition and that is cataract surgery followed by a lens replacement, known as an intraocular lens or IOL. If you notice any changes in your vision, especially if you are around age 60 or above, please schedule an appointment with your eye doctor to check your eye health and to find out if you have cataract.

Cataract surgery is generally an outpatient procedure, meaning it does not require an overnight stay at the hospital and it often takes an hour or less. It is a very common and highly successful surgery which removes the part of your lens inside of your eye that has become cloudy. The most contemporary approach to this procedure is to leave inside your eye the outer sac layer of the lens in which your lens sits. Preserving this part of the sac allows for successful implantation of a tiny artificial lens which is about a third of the size of a dime and it’s called the IOL. This new intraocular lens does not require any maintenance, you don’t see or feel it and it simply becomes part of your eye, enabling you to see so much clearer than you were seeing prior to cataract surgery.

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Considerations Prior to Surgery

Cataract surgery is most often a non-emergency procedure. A person may have cataract for many years before deciding to go through with the operation. The main indication for surgery is when the cataract starts making day to day functions more difficult. In other cases, if cataract is interfering with other pre-existing eye conditions, one might be advised to have cataract surgery.

In order to make sure that you are a proper candidate for cataract surgery, you will first have a very thorough eye exam which will check your visual acuity, the health of your eyes, and various other necessary measurements. You will be asked to share a full medical background, including all medications you are taking and if you have any allergies. Your eye doctor will help you decide if cataract surgery is the right step for you.

Choosing the Most Fitting IOL

If you decide to get cataract surgery, a very important step before the operation is figuring out which intraocular lens will best suit your needs. The natural lens inside of our eyes is responsible for performing the incredible task of providing clear vision at different distances which requires the lens to bend in different ways in order to reflect the incoming light in a way that enables us to see. During cataract surgery, your lens is removed and gets replaced with an artificial IOL. Like glasses and contact lenses, IOLs are available in different powers. The eye doctor will also measure the curvature of your cornea and the length of your eye in order to provide the best fit for your IOL.

Your eye doctor will explain to you the various types of artificial lenses that you can choose from and together you will decide which kind best suits your lifestyle and can fit your budget. There are different kinds of materials that the IOL is made from such as plastic, silicone, or acrylic. Some artificial lenses have a special feature of being able to fold which provides flexibility and some IOLs block ultraviolet rays from the sun. Today, there are so many different types of optics that the intraocular lenses can provide, these include:

  • Monofocal IOL: This is the most common type of IOL and it provides clear sharp vision at one distance which could either be near, far or intermediate. Most people choose to have clear vision at a distance and then compensate with reading glasses which they only wear when they need near vision.
  • Accommodative IOL: This type of intraocular lens is able to change shape or to move, in order to provide vision at both near and far distances, similar to a natural lens.
  • Multifocal IOL: The multifocal IOL is similar to using multifocal glasses but the same concept is incorporated into the artificial lens inside of your eye. Different areas of the IOL are set to different powers which provide sharp vision at various distances.
  • Toric IOL: This kind of artificial lens provides the proper optical correction for people with astigmatism, which is a common refractive error due to the shape of your cornea.
Choosing the Most Fitting IOL
Surgery

Surgery

After all preparations are made before the operation, you will also be given medicine to take in the form of eye drops for a few days leading up to the surgery. Your eye will be numbed right before the operation and you will be given a drug that will help you relax. During the procedure, you might see light but you shouldn’t feel anything, other than gentle pressure. During the surgery, your cloudy natural lens will be removed and replaced with the artificial IOL. This procedure does not require stitches and your eye can heal on its own. Most often, you can go home in less than an hour but someone else must drive you. Any procedure has a risk of complications but cataract surgery is not considered to be a risky one. It is possible to have post-op complications but the chances are very low and the eye doctor will do everything possible to avoid that and when necessary, to guide you through it.

Surgery

Post-Op Care

It takes around 8-12 weeks for the eye to fully heal, but many people enjoy the benefits of being able to see so much clearer than they were seeing prior to surgery anywhere from a few hours after surgery to a week or two post-op. It is recommended that you wear sunglasses during these weeks and that you sleep with an eye shield. Your eye doctor will prescribe medicated eye drops that you will use for a number of weeks.

Common Questions

Cataract is when the lens inside your eye becomes cloudy, making it more difficult to see clearly. Common symptoms include blurry vision and being sensitive to light, often seeing glare. This kind of impaired vision can make driving very difficult, especially at night. In addition, if you have cataract, you may notice that reading becomes more challenging. Some people notice that colors appear more dull than usual and that trying to perform fine motor skills up close, such as threading a needle, becomes increasingly difficult. If cataract becomes serious, it can cause various accidents such as tripping or falling. The main indication for cataract surgery is when performing daily tasks is becoming too challenging.
There isn’t one correct answer for this question because choosing an artificial lens is a personal decision that needs to be made to customize your daily needs. Our staff will gladly spend the time discussing the various options available and what most suits your lifestyle. Is it important to you to have the sharpest and clearest vision when you look at a distance? Do your most essential daily tasks involve driving or any other activity that requires distance vision? Or do your hobbies and responsibilities involve clear vision up close? Maybe you want to be able to see both at a distance and at near. Each lens has its own advantages and limitations and your eye doctor will be happy to weigh out the benefits and compromises that this decision could involve. There are other considerations as well, such as other present eye diseases. Some people with macular degeneration, glaucoma or various corneal conditions may require a certain type of IOL which will be appropriate for their eye health. You won’t have to make this decision alone. Our staff is here to help you make the optimal choice so that you will be satisfied with your vision after cataract surgery.
In the US, the majority of cataract surgeries are performed under local anesthesia, with the patient remaining awake during the procedure. Topical drops and injections are both options for administering anesthesia. Surgery performed with an injection of anesthetic around the eye generally produces a deeper anesthesia than when applied topically; however, there is also an increased risk. The needle may hit the back of the eye and there is a very small but potentially serious risk of bleeding behind the eye. Even though topical anesthesia is less risky, it does not provide a deep level of anesthesia. In most cases, topical anesthetics do not cause significant pain during cataract surgery.
Cataract Surgery and IOLs
Dr. Wernick cartoon

Summary

We are fortunate to be living in a time period where there is such a successful procedure available to provide clear vision to people who have cataract. Cataract surgery replaces your cloudy lens inside of your eye with an artificial lens, known as an IOL, that provides sharp vision and allows you to enjoy daily life with clear eyesight.

Testimonials


  • At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


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  • Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.


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  • Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


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  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


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  • Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


    Kinkie F.

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