Cataracts

Thank you for consulting Maryland Eye Associates regarding your cataract care. The purpose of this page is to educate the reader about cataracts and their treatment. If you have questions after viewing this information, please make an appointment to see us.

For your convenience and further education view this video http://www.aao.org/eye-health/diseases/what-are-cataracts.

A cataract is a cloudiness or haze in the natural lens of the eye.  The affect of a cataract is that light which is taken in by the eye is scattered, resulting in impaired vision.  More than 50 percent of individuals over the age of 60 will have some degree of cataract, and quite a few younger than that, especially in diabetics, following trauma, or with the use of certain prescription drugs such as prednisone. The progressive clouding of the lens causes symptoms such as blurred distant and/or near vision, halos and glare with lights, difficulty driving or reading, double vision, and decreased vision in either dim or bright light. Frequent changes in eyeglass prescriptions may also be a sign of cataract formation.

There is no medical treatment to date to reverse or arrest cataract formation, either in oral or eyedrop medications. The only successful current treatment is surgical removal of the clouded natural lens. When the natural lens is removed, an artificial lens is inserted in its place: an intraocular lens, also known as an “IOL”, or lens implant.

 

 

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Modern Cataract Surgery

When your grandmother had cataract surgery she probably stayed in the hospital for two weeks with sandbags around her head to prevent movement. As late as 1980, a three-day hospitalization was in order.  Today, however, the technique of cataract removal has changed.  One technique uses a small (1/8 inch) incision and a method called “phacoemulsification”, cataract extraction and IOL placement.  Currently the most common method of removing a cataract involves a technique called “phacoemulsification” in which pulsed ultrasound energy is used to gently break up the cataract into microscopic fragments which are then aspirated from the eye. This technique is also used by Maryland Eye Associates surgeons.  Another even more modern technique involves the use of the LenSx® Laser by Alcon.  This is the first femtosecond laser cleared for use in cataract surgery.  It brings image-guided computer precision to refractive cataract surgeons.  Both surgeries are safely performed as outpatient procedures, with a brief pre- and post-operative monitoring period.

Cataract surgery is comfortably performed under local or topical anesthesia and takes from 10-25 minutes. With the phacoemulsification technique, the cataract is fragmented into microscopic particles using high energy sound waves, and gently aspirated from the eye. Following phacoemulsification, the tiny incision is determined to be self-sealing, or is closed with a single suture. With the LenSx technique, a perfectly sized and centered incision is formed via laser, the cataract is then fragmented and removed.  Your ophthalmologist will discuss a personalized surgical plan with you.

Intraocular Lenses (IOL’s)

The lens implant inserted at the conclusion of the procedure is designed to provide clear vision, with fine-tuning usually required in eyeglasses for your best distance and near vision. A survey conducted by the American Society of Cataract and Refractive Surgeons found that more than 98% of cataract patients had their vision significantly improved following cataract surgery, and Maryland Eye Associates’ statistics follow this national survey result.

Lasers and Cataracts

Maryland Eye Associates brings yet another technologicial advance to Southern Maryland!  On September 24, 2013, Maryland Eye Associates performed the first laser assisted cataract surgery in Southern Maryland.  The surgery was performed at The Surgery Center in Prince Frederick, Maryland.  Dr. Benderson and Dr. Dodd used the latest innovation in cataract surgery, the Alcon LenSx femtosecond eximer laser, and implanted the latest generation of multifocal and toric intraocular lenses to provide the most advanced cataract surgery available anywhere.  Directly following these surgeries, Dr. Benderson wrote an article for Your Health Magazine regarding laser assisted cataract surgery.  Dr. Benderson’s article, “Laser Assisted Cataract Surgery: A New Paradigm?” can be viewed online.  If you have been told that you have a cataract or if your vision has been deteriorating gradually over time there is no longer for you to go to Baltimore or Washington DC to receive this breakthrough treatment.  Call 410-535-2270 and make an appointment with Dr. Dodd or Dr. Benderson at any one of Maryland Eye Associates three convenient locations!

When to Operate
Patients frequently ask: “When should I have my cataract removed?” Cataracts develop at variable rates, usually over years, although some may progress over a few short months. The time to have your cataract removed is when you feel that you are unable to comfortably perform your daily visual tasks, and when you feel your blurred vision is interfering with your quality of life. After a thorough eye exam, if your ophthalmologist determines that all or most of your visual discomfort is due to a cataract, and that your eye is otherwise healthy, then “go for it”.

After Surgery

Early Care

Your doctor and eyecare team will give you step-by-step instructions following surgery, but recovery is usually quite easy. Immediately after surgery you will likely wear an eye patch for approximately 24 hours, until your first post-operative office visit the day after surgery. During the first few weeks of recovery, you will have a simple schedule of eyedrops to instill, usually an antibiotic to prevent infection, and an anti-inflammatory drop to control the normal postoperative inflammation. Restrictions on your activity are few with these modern techniques of surgery. No more: “don’t bend over or lift or sleep on that side” you may have heard in the past. Your Doctor will give you your specific instructions, depending on your eye’s response to surgery. Visual acuity in the first several weeks is variable from patient-to-patient, and may be very clear or somewhat blurred. You are using your new vision from the day the patch is removed, and may pursue normal activities, including driving, when your common sense tells you it is safe. After 4 to 6 weeks, the eye has healed and stabilized sufficiently to prescribe any change in eyeglasses which may be necessary to “fine-tune” your vision.

Later Issues

Another frequently asked question is: “Will my cataract grow back?” No, removal of a cataract, or clouded natural lens, is permanent. However, vision may become gradually diminished months or years after cataract removal due to a clouding of the lens capsule, a portion of the natural lens left in place intentionally at cataract surgery. This clouding causes symptoms similar to early cataract formation: blurred vision, glare, problems reading or driving.

YAG Laser Capsulotomy

This is a relatively common occurrence, and is safely and simply taken care of with a laser treatment. The laser, known as a “YAG” laser, creates a small clear opening in the cloudy capsule, returning vision to the clarity achieved following the initial cataract surgery, as long as the eye is otherwise healthy. This is an office procedure, after which activity is unrestricted, and visual recovery is rapid.

If you have any questions regarding cataracts or cataract surgery, please ask your opthamologist. You may send your questions to Maryland Eye Associates at admin@marylandeyeassociates.com