Most people develop cataracts simply as a result of aging, with the majority of cases occurring in people over the age of 55. Other risk factors include eye injury or disease, a family history of cataracts, smoking or use of certain medications.
For people who are significantly affected by cataracts, lens replacement surgery may be recommended. During cataract replacement, the most common surgical procedure in the country, the lens is removed and replaced with an artificial one called an intraocular lens or IOL.
Because the cloudy lens allows less light to reach the retina, distance and reading vision is often fuzzy and indistinct through the affected eye. Other symptoms of cataract include diminished color perception (especially blues and purples), annoying glare in sunlight, poor night vision, and excessive glare from oncoming headlights. Frequent changes in eyeglass prescriptions may also be a sign of cataract formation.
What to Do
If you suspect a cataract, call our office to schedule a simple, painless screening exam. Fortunately, today there is a relatively straightforward procedure for the replacement to the eye's natural lens with a clear lens implant called an "intraocular" lens.
What Kind of Treatment
To date, there is no medical treatment 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.
CATALYS Cataract Surgery
Cataract surgery removes the cloudy lens and replaces it with a clear artificial lens called an IOL (intraocular lens).
Catalys Precision Laser System-Femto Second Laser
Metro Eye Care is the first in Bergen County to offer patients the new standard in precision cataract surgery with the CATALYS Precision Laser System. Using CATALYS, Dr. Pomerantz can provide a gentle, highly customized cataract procedure with precision not achievable with traditional manual techniques.
What is CATALYS?
Developed by Silicon Valley-based OptiMedica Corp., CATALYS is a new FDA market cleared medical device that features a state-of-the-art laser, advanced 3D imaging, and many other innovative features that can bring numerous benefits to our patients.
How does it work and what are the steps?
Every eye has a unique size and shape. CATALYS’ advanced 3D imaging technology builds a 3D map of each eye and tailors the treatment to that map. This enables Dr. Pomerantz to create a customized treatment plan that matches the uniqueness of each eye.
Next, Dr. Pomerantz uses CATALYS to create a circular opening for accessing and removing the cataract. Clinical studies have shown that this opening is approximately 10 times more accurate when performed with CATALYS than what is achievable by hand. CATALYS then softens and breaks up the hard cataract into tiny pieces, allowing for gentler, easier cataract removal.
Depending on the patient’s pre-operative vision and desired visual result, Dr. Pomerantz may recommend a tailored treatment plan that could include creating ultra-precise laser incisions in the cornea and a specific clear lens type, such as a multi-focal lens. This tailored treatment may reduce a patient’s need for glasses or contacts after surgery.
What are the benefits of CATALYS?
- A highly customized procedure using advanced 3D imaging
- A treatment with little or no discomfort
- A more precise treatment
- A gentler and easier cataract removal
- Generally, a more rapid visual recovery due to reduced inflammation
- The opportunity to receive tailored treatment with advanced technology multi-focal lenses, which may reduce the need for glasses or contacts after surgery
Traditional Cataract Surgery
We perform a minimally invasive, small-incision, no-stitch cataract surgery called phacoemulsification (“phaco”) surgery. First, the eye is numbed with anesthesia. Then a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the coloudy lens into tiny pieces.
After the cloudy lens has been removed, a new artificial lens, or IOL, is implanted in the eye. With the recent advance of foldable IOLs, artificial lenses can be implanted through the same small incision from the phaco procedure.
To explore the differences between Laser and Traditional cataract surgery, click - Laser Versus Traditional Cataract Surgery.
Intraocular Lenses (IOLs)
Intraocular lenses are about the size of Lincoln's head on a penny and weigh about the same as a kernel of corn. They are polished to the precise curvature needed to bend light rays into focus on the retina at the back of your eye. The lens itself is made of an inert material and is designed to provide good vision for the rest of your life.
Tecnis Multifocal IOL
Tecnis Multifocal IOL Manufactured by Abbott Medical Optics, the Tecnis® Multifocal IOL helps cataract patients achieve clear vision at all distances after surgery, including improved night vision and driving capabilities. Using wavefront technology, the Tecnis lens allows patients to restore the clear, functional vision of their youth. After surgery, up to nine out of ten patients no longer need to wear glasses, results much more successful than those achieved with standard multifocal lenses. It is the only lens FDA-approved to enhance functional vision and night-driving performance. The advanced Tecnis lens is ideal for patients who have difficulty reading and seeing objects closely, as well as those with poor night vision. This lens is implanted during the same procedure that removes the cloudy lens, and does not require any additional incisions. Patients can enjoy immediate vision improvement in most cases.
Physicians have been using flexible IOLs for years to replace the eye's cloudy lens during cataract surgery and help patients enjoy clear vision again. The ReSTOR® lens improves upon the ordinary IOL by using apodized diffractive technology to provide a full range of focusing distances from near to far. A series of 12 gradual "step heights" of 0.2-1.3 microns each (thinner than a human hair and smaller than a red blood cell) in the center of the IOL create seamless focusing ability, while the peripheral refractive region helps to enhance distance vision. Apodization also allows the lens to work with the pupil to distribute light evenly in the eye in different lighting conditions and activity levels. Alcon® reports that up to 80% of patients who use the ReSTOR lens don't need glasses after surgery.
AcrySOF Toric IOL
Toric IOLs are specially designed for patients with astigmatism. Traditionally, surgical correction of astigmatism required making a series of small incisions (called LRIs) around the cornea to make it more spherical instead of football-shaped. Implanting toric IOLs often improves vision due to astigmatism without the need for these extra incisions, and also allows patients to enjoy a faster, more comfortable recovery.
What is the Capsule?
The natural lens of the eye is held in place by a thin clear membrane called the lens capsule. The capsule completely surrounds the lens and separates it from the thick fluid in the back of the eye, called the vitreous, and the thinner fluid in the front of the eye, called the aqueous.
Cataract surgery is necessary when the natural lens become cloudy and must be removed. When cataract surgery was originally performed, surgical techniques were not as refined as today, and both the natural lens and the capsule were removed during surgery. Newer techniques allow the capsule to remain in the eye and hold the implanted lens (or intraocular lens) in place. Leaving the capsule in place during surgery is a great advancement because it allows the vision after surgery to be more stable and provides for less surgical complications.
Cataract Surgery Affects the Capsule:
Sometimes the posterior, or back, portion of the capsule becomes cloudy after cataract surgery. The reasons for this cloudiness are unknown. If the posterior capsule becomes so cloudy that it detrimentally affects vision, then a capsulotomy is performed.
YAG Laser Capsulotomy
After modern cataract surgery, it is common for a plastic lens to be placed in the eye, replacing the eye's own lens. Sometimes the transparent membrane against which the plastic lens is placed begins to go cloudy, making it difficult to see clearly. This usually happens some weeks or months after the cataract operation.
The YAG laser is used to clear the membrane and restore clear vision. The treatment takes just a few minutes in the outpatient clinic, and involves very little discomfort.
Eye drops may be given to dilate the pupil and to numb the front of the eye before a special contact lens is placed on it. A beam of red light is used to aim the laser before it is operated. You may hear a 'click' each time the laser is fired.
Afterwards, it is sometimes necessary for more eye drops or tablets to be dispensed. They help to protect against any short-term increase of pressure in the eye.