Cataract Surgery

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WHAT IS A CATARACT?
A cataract is a clouding of the natural lens of the eye. The eye is very much like a camera. The lens of the eye is like the lens of a camera and the retina of the eye is like the film in a camera. When the lens of the eye becomes cloudy, like a dirty camera lens, light rays cannot pass through it easily and your vision is blurred and you do not get a clear picture.
Cloudy lens

Cloudy lens (cataract) causing blurred vision

WHAT CAUSES CATARACTS?

Cataracts are part of the normal aging process. They also can be caused by injuries, medications such as steroids, certain diseases or long term exposure to sunlight. Genetics may also play a role in cataract development.

HOW ARE CATARACTS TREATED?

When cataracts are just developing and your vision is only slightly blurry, changing your glasses may help improve your vision.

The only curative treatment for cataracts is surgery. There are not any medications, vitamins or eyedrops that will make them disappear.

The need for surgery is determined by how much the poor vision caused by the cataracts interferes with your lifestyle. When your normal daily activities are affected like driving, reading, sports or hobbies, then cataract surgery may be necessary.

In cataract surgery, the cloudy lens is removed from the eye and is replaced with an artificial lens called a lens implant or IOL.

WHAT CAN I EXPECT IF I HAVE CATARACT SURGERY?

BEFORE SURGERY:

To determine whether you need surgery you will need a thorough eye exam performed by Dr Clark at Clark Eye Center. Once it is determined that cataract surgery is going to help your vision, you will be given a date for surgery. You will also be scheduled to have your eye measured to determine the strength of the intraocular lens implant. This is usually performed a week or two before surgery.

You do have a choice regarding what type of IOL you wish to have in your eye. The traditional lens is called a monofocal lens. It is usually measured to give you excellent distance vision but you will still need glasses especially for reading. You will also have the choice of a specialty lens that will give you more freedom from glasses. You can choose from a lens to correct only your astigmatism (Toric lens), multifocal lens (Restor, Tecnis) or an accommodative lens (Crystalens). Dr Clark and his staff will give you recommendations as to which IOL is best for your eyes. There is also more information in this website regarding these choices.

The surgery can be scheduled at the Surgical Center in the office building, Huron Valley – Sinai Hospital or Beaumont Hospital. You need to make arrangements to have someone accompany you to the surgical center and to drive you home.

THE DAY OF SURGERY

Surgery is performed on an outpatient basis. You will be asked to not eat or drink from midnight the day prior to surgery.

When you arrive for surgery, you will be given eye drops in the form of a small sponge and mild sedative to relax you. A topical anesthetic will numb your eye. Your skin around your eye will be thoroughly cleansed and sterile coverings will be placed around your head. You may see light and movement during the surgery but you will not be able to see the surgery while it is performed.

Under the microscope, a small incision is made in the eye. An instrument called a phacoemusifier is used to break the cataract into tiny pieces using ultrasound. At the surgical center in the office, the Bausch and Lomb Stellaris is used. It enables Dr Clark to use a sub-2 millimeter incision. He is one of the few eye surgeons in the Midwest performing this technique. The implant or IOL is then implanted to replace the natural lens that was removed.
phaco_implant

Phacoemulsification of the cataract                                          Lens implant in the eye

After surgery is completed, you are taken to the recovery area for a short stay. You do not need a patch on your eye. Instructions are given to you and your companion and you are ready to go home.

FOLLOWING SURGERY

You will need to use the eyedrops as prescribed. You will be asked to place a clear plastic shield over your eye at bedtime for 5 nights. It is recommended that you avoid strenuous activities for 5 days. Pain medications are rarely needed. Otherwise, you can resume your normal activities.

COMPLICATIONS AFTER CATARACT SURGERY

Serious complications are rare after present day cataract surgery. Infection, swelling of the retina or cornea, and retinal detachment are the most serious compilations to look out for.

You need to call the office immediately if you are having any of the following symptoms:
• Pain not relieved by non-prescription pain medications
• Loss of vision
• Nausea, vomiting or excessive coughing
• Injury to the eye

Even if cataract surgery is successful, some patients may not see as well as they like to. Other eye problems such as macular degeneration, glaucoma or diabetic retinopathy may limit vision after surgery. Even with these problems cataract surgery may still be worthwhile. You need to talk to Dr Clark regarding the risks and benefits of cataract surgery.