New and Exciting Developments in Cataract Surgery
There is a common misconception dating from ancient times, that a cataract is a film that grows across the eye. In fact, a cataract is the protein of the natural lens that gradually becomes cloudy, just as egg white turns opaque as it is cooked or “denatured” as it is scientifically described. Since we do not know how to “uncook” an egg, we cannot undo a cataract. Therefore, we are required to remove the cloudy lens and replace it with a clear lens, called an implant, in order to restore clear vision.
Recently, we have witnessed tremendous advances in cataract surgery technology, both the surgical technique itself as well as new opportunities for visual rehabilitation with the intraocular lens. Although the standard techniques are quite successful and remain an option for patients, these new techniques promise greater safety and greater range of vision after surgery.
Astigmatic or Toric Implants: for those patients who have pre-existing astigmatism, astigmatic or toric implants can significantly reduce the astigmatic need for glasses. Astigmatism generally is an asphericity of the cornea, that is, the cornea is not perfectly round but is shaped somewhat like a spoon with a steeper meridian and a flatter meridian usually 90 degrees apart. With astigmatic implants, the cornea remains astigmatic but the implant helps compensate just as wearing glasses compensates for the astigmatism of non-surgical patients. Astigmatism affects both distance and near vision.
Crystalens ™ or the Accommodating Implant: For patients, who are candidates, the Crystalens ™ or the accommodating implant can help correct for the “presbyopia” or the natural loss of focusing that occurs as the eye matures. Perfectly normal vision in youth often translates to the need for reading glasses as one enters middle age. The Crystalens ™ implant is designed to restore some of the accommodation that has been lost as we mature. This allows both clear vision at distance and increased reading ability compared to the standard implant.
Femptosecond Laser Cataract Surgery: The latest advance in cataract surgery is a laser that assists the surgeon in creating precise incisions and softening the cataract such that less ultrasound energy is needed to remove it. The laser can perform critical incisions with ten times the precision compared to the standard, manual technique. This offers the promise of more reliable implant power calculations, increased precision and safety. Furthermore, for many patients with moderate astigmatism, the laser can treat the astigmatism directly obviating the need for a toric or astigmatic intraocular lens.
No technology, new or old is absolutely perfect all the time. However, these new technologies represent a major step forward in cataract surgery. As you might expect, in today’s insurance climate, the major insurers including Medicare will not pay for these innovative improvements even though they are all FDA approved. Therefore, there usually is an out of pocket component should you wish to take advantage of the new technology. Our office will make every effort to assist you in your decision with clear recommendations, a thorough discussion of alternatives and a clear explanation of the costs to you.