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Glendale Office • Scottsdale Office • Surgical Centers

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Premium Cataract Surgery

During cataract surgery, the eye is sterilized with a disinfecting solution, and the a sterile surgical drape and eyelid speculum (holds the lids open) are placed. Cataract surgery takes about 10-15 minutes to complete.

Premium Cataract Surgery

A small incision is made in the cornea. The lens sits in a bag, called the capsule. A small hole is peeled in the capsular bag, called a capsulorhexis. Utilizing high frequency ultrasound energy, the cataract is broken up and removed. After ensuring all portions of the cataract are removed, the chosen IOL is inserted into the bag and checked for stability. The incisions are then evaluated to ensure they are water-tight.

 

Recovery

You are typically seen by your doctor the day after surgery to ensure the healing process is progressing well. Typically, you may wear a shield at bedtime and have moderate limitations for the first few weeks, but discuss this with your doctor for specific instructions.

Long-term Recovery

Once cataract surgery is completed, you will not develop another cataract, however, you may develop a film, or a posterior capsule opacification, behind the IOL. This commonly occurs in up to 50% of patients, and presents with symptoms very similar to the original symptoms of cataract — blurriness of vision and glare. Fortunately, when this occurs, a laser surgery, called a YAG capsulotomy, can be performed.

For this procedure your eye will be dilated to allow for a better view of the film. The laser takes about 5 minutes to complete, and you may take anti-inflammatory drops for 1 week after surgery. Once the laser is complete, your vision should improve over the next few days.

Catering Cataract Surgery to your visual needs

During cataract surgery, your natural lens is replaced with an intraocular lens (IOL). This IOL determines the focusing ability of your eye. The single vision lenses do not have the ability to change their focusing point, and therefore are “aimed” for a certain distance; near, intermediate or distance.

When we choose the IOL for your eye, we determine the necessary power based on the anatomy of your eye. The IOL is placed in the eye at the time of surgery, and based upon your healing process, you may or may not need glasses after surgery.

  • A near aim is best for patients who are near-sighted and do a significant amount of reading or fine work. In this case, you would wear glasses for distance and intermediate vision.
     
  • An intermediate aim is for patients who do a significant amount of computer work. In this case, you would wear glasses for distance and near.
     
  • A distance aim is for patients who wish to be “glasses-free” for distance. You would wear glasses for intermediate and near activities.

Another option includes something called MONOVISION, where the dominant eye (which we will test for) is set for distance and the other eye is set for near. While this does compromise some depth perception, it does offer the opportunity to be “glasses-free” without the added investment of the premium lenses. Monovision is best for patients who have had the same type of vision in contact lenses or glasses before, as there is an adaptation period associated with monovision.

If you have astigmatism or are interested in our premium lenses, please read about the Premium IOL’s.
As with any other issue regarding your eye health, if you have any questions or comments, we would be happy to discuss them in detail with you during your appointment.

During cataract surgery, after removing your cataract, we will insert an intraocular lens (IOL). Single vision IOL's are the most commonly implanted lenses, but do not correct astigmatism or provide independence from glasses. New lenses, called premium IOL's, offer astigmatism correction and multifocal correction. While these IOL's are not covered by medical insurance, they may be an excellent option for the right person.

Cataract Surgery ScottsdaleAstigmatism-correcting IOL's (Toric IOL's):
Astigmatism is most commonly from the shape of the cornea or the cataract itself. Astigmatism that is from the cataract will be corrected with cataract surgery. Corneal astigmatism will be identified through our preoperative measurements with the Lenstar. In an optical system, such as the eye, the curvature of the cornea works with the lens to focus light on the retina. If the cornea is shaped more like a football than a basketball, the image that is focused on the retina will not be completely sharp. The shape of the cornea can be altered with refractive surgery. Alternatively, during cataract surgery, a toric IOL may be implanted to counteract the astigmatism that exists in the cornea.

If, based on our measurements, you qualify for a toric IOL, your eye physician will discuss this option with you. In addition to the routine surgical procedure, the IOL has to be placed at the correct axis (or degree) to ensure the lens correctly addresses the corneal astigmatism. With successful surgery, patients often see "better than they ever have" after cataract surgery.

Accommodating IOL's (Crystalens):
Standard cataract surgery includes the implantation of an IOL that clears your view for a single distance (based on the power of the lens chosen). However, since it is a single vision lens, you will use glasses for other tasks. For example, if the power of the IOL is chosen to give you the best distance vision, then you will wear glasses for intermediate (computer) and near (reading) distances.

Accommodating IOL's, or the Crystalens, takes advantage of the eye's natural ability to focus to reduce a person's dependence on glasses. With the natural lens, the eye is able to focus, or accommodate, by relaxing the fibers (zonules) that hold the lens in place. The Crystalens has two hinges on the edge of the optic that allow it to move its position within the eye based on tension of the zonules. When we are trying to see up close, the zonules relax, and the lens is pushed the front of the eye. When we are trying to see far away, the zonule tension increases, and the lens is pushed to the back of the eye.
Our zonular flexibility decreases over time, and consequently, the lens can not move quite as much as we may need it to for the nearest of tasks. Therefore, patients often use glasses for their near work.

In addition to the routine surgical procedure, you will receive a dilating drop at the end of surgery to allow the lens to set into the correct position. Your eye physician may also ask you to avoid near tasks. During the healing process, your eye physician will discuss various exercises to improve your outcome as well as use anti-inflammatory drops for a longer period of time.

Multifocal IOL's (Restor, Tecnis Multifocal)
Standard cataract surgery includes the implantation of an IOL that clears your view for a single distance (based on the power of the lens chosen). However, since it is a single vision lens, you will use glasses for other tasks. For example, if the power of the IOL is chosen to give you the best distance vision, then you will wear glasses for intermediate (computer) and near (reading) distances.

Multifocal IOL's utilize something called diffractive optics. These lenses have concentric rings that have different focal lengths, alternating between near and far distances. These lenses give the greatest chance for independence from glasses, but have side effects that include glare and halos at night from the edges of the concentric rings. It does take some time to get accustomed to the multifocal IOL's, and the best outcomes are in patients who have had the multifocal lenses implanted in both eyes.

There is typically no additional recovery period or preparation for the multifocal IOL implantation. There are three types of multifocal IOL's currently being used; the Restor lens and the Tecnis MultiFocal lens.