We want you to know that we understand what an important decision it is to have cataract surgery, and that we appreciate your confidence and trust. Be assured that we will always provide the most current, state-of-the-art, clinical and surgical techniques available today.
Symptoms of Cataracts
Dimming and blurring of vision
Halos around lights at night
Frequent changes or cleaning of glasses
What is a Cataract?
A cataract is a slow, progressive clouding of the eye's natural lens. It interferes with light passing through the eye to the retina. Cataracts are caused by a change in the proteins of the eye, which causes clouding or discoloration of the lens. Over time cataracts typically result in blurred or fuzzy vision and sensitivity to light. People with progressed cataracts often describe the sensation as looking through a piece of wax paper. Once the lens opacifies, usually due to aging, light rays become obstructed and vision becomes dim and hazy. When this occurs, it is called a cataract. Heredity, disease, injury, and medications can also play a role in the development of cataracts. A cataract may make light from the sun or a lamp seem too bright, causing glare. Colors may not appear as bright as they once did, however, most cataracts develop so slowly that people usually don’t realize that their color vision has markedly deteriorated. Oncoming headlights may cause uncomfortable glare at night, making driving more difficult.
There is a myth that cataracts have to “ripen" before they can be removed. This was true before about 1930, when the surgical technique to remove cataracts was quite primitive and the surgical outcome was not great, even in uncomplicated cases. Patients essentially had to be blind from their cataract before surgery, so they could appreciate the poor vision that their very thick glasses provided after surgery.
These days, the average cataract patient usually sees better after surgery than his peers who may have minimal cataracts. We do wait until the patient finds that the cataract is interfering in his lifestyle - patients have cataract surgery because they are having difficulty seeing the golf ball, reading their Bibles or the financial pages, or have difficulty driving at night.
The most common response on the day after surgery is, “When can I have the other eye done?” followed by “Why did I wait so long?”
Clear Cornea Cataract Surgery
In clear cornea cataract surgery, a micro-incision is made into the perimeter of the cornea on the side of the eye which is closest to the temple. This tiny incision ( 3 mm or less ), provides a space through which the cataract is removed and an intraocular lens is injected. It is the architecture of this incision which makes it self-sealing. Clear cornea cataract surgery can be performed under topical or local anesthesia on an outpatient basis at our own ambulatory surgery center.
What is Phacoemulsification ?
Clear cornea cataract surgery utilizes an ultrasonic probe, called a phacoemulsifier, which vibrates 40,000 times per second to break a cataract up into tiny microscopic pieces which are vacuumed out of the eye through the micro-incision. In traditional cataract surgery, a much larger incision is needed because cataracts are removed in one piece.
What is an Intraocular Lens?
When the clouded lens is removed during cataract surgery, a replacement lens is needed to restore focus to the eye, these lenses are called intraocular lenses (IOLs). Prior to surgery, the patient's eye is measured to determine the prescription of the IOL needed for the patient to achieve the best possible vision. The IOL is then surgically implanted in the same chamber that once housed the natural lens of the eye. It was with the advent of foldable IOLs that phacoemulsification became the best way to remove cataracts, because foldable IOLs could be injected through the same micro incision used to remove the cataract, thus making small incision surgery possible.
How Will I Know When I'm Ready for Cataract Surgery?
The decision to have cataract surgery is best left up to the patient. For the active retiree or working person who depends on sharp vision to carry out their daily tasks, the decision to have cataract surgery might be made sooner, but generally patients decide to have cataract surgery when they begin to have trouble reading, watching television, or driving a car. Some cataracts are slow to form while others mature in only a matter of months. Your doctor can give you an estimate as to when your cataracts might be ready for surgery.
What are the Benefits of Clear Cornea Cataract Surgery?
Clear cornea cataract surgery offers many benefits to patients, primarily due to the size and location of the micro-incision. In traditional, and other small incision cataract surgery, incisions are made above the iris, not temporally, and usually require one or more stitches to close, which can cause post-operative astigmatism. In clear corneal cataract surgery, no stitches are needed, and it can be performed under topical or local anesthesia. The results are a faster recovery, less surgically induced astigmatism, a quicker return to normal activities, and fewer complications.
What are My Choices?
At your evaluation for cataract surgery, your eyes will be measured to determine the best power for the lens that will be implanted. However, there are still a few choices for you to consider. Please inform the doctor if you are interested in any of the upgraded lens options:
This lens, covered under medical insurance, provides a single focus when you are not wearing eyeglasses. Usually, your lens will be set to focus at a distance. You may still need glasses for reading or other activities that require close-up vision.
Astigmatism Correction Surgery
This surgery is the same as above, using the same monofocal lens. However, if you have astigmatism, your surgeon may be able to better improve your vision through making some tiny, relaxing incisions in the cornea.
For patients with astigmatism, the best lens choice is a toric lens - a customized lens that not only corrects your vision, but can also correct the astigmatism in your eye. Toric lenses are an upgrade in cost, but they will provide quality vision with decreased dependency on eyeglasses, as they can remove all astigmatism in 99% of all cases.
Symfony Extended Range of Vision Lens
For patients experiencing the symptoms of presbyopia, Dr. Bruening may recommend this new toric multi-focal lens. This lens can potentially reduce your dependence on glasses for many daily tasks, such as driving, reading and using a computer. Symfony lenses are an upgrade in cost, but they will provide quality vision with decreased dependency on eyeglasses.
Symfony Toric Extended Range of Vision Lens
For patients experiencing the symptoms of both astigmatism and presbyopia, Dr. Bruening may recommend this new toric multi-focal lens. This lens can potentially correct not only your astigmatism, but it may reduce your dependence on glasses for many daily tasks, such as driving, reading and using a computer. Symfony Toric lenses are an upgrade in cost, but they will provide quality vision with decreased dependency on eyeglasses.
What Happens After Surgery?
Prior to leaving the surgical facility, postoperative instructions will be discussed with you. With clear cornea surgery, you should reach your best vision within a few days and most normal activities can be resumed almost immediately.