Cataract Surgery: Understanding the Basics

By Balaji K. Gupta, M.D.

About three million cataract procedures are performed annually, making it the most common surgery in the United States.

But most people don’t truly understand the ins-and-outs of cataract surgery. Here’s some insight that will get you up to speed.

Definition
The lens in the eye is one of the few structures in the body that is transparent. When we are born, it is a clear, beautiful, focusing lens. As we age, though, proteins in the lens turn yellow, develop white patches, and create worse vision. Any haze in our crystalline lens is a cataract.

Symptoms
You can have 20/20 vision and still suffer from cataracts.  With cataracts, however, you will not be experiencing the magic of vision – the beautiful vibrancy of colors and the ability to see in low-light situations or at night.  In addition, as cataracts form, you might experience cloudy vision, glare or even double vision. 

Many people with cataracts find it difficult to engage in work and leisure related activities, a huge concern for an aging population, which now includes people who want to lead active, fulfilling lives well into their golden years. Besides interfering with work related activities, cataracts can inhibit leisure pursuits such as golf, reading and art.

Prevention
Cataracts are a natural part of the aging process and are inevitable for many people. Even though research has not absolutely confirmed reliable prevention tactics, some common-sense steps can at the very least delay the onset of cataracts.

First off, pay attention to your overall health. By eating right, exercising and maintaining a healthy weight you could delay the onset of cataracts. Second, limit your exposure to ultraviolet light. A study of fishermen who were constantly exposed to large amounts of sunlight showed that such exposure increases the chances of developing cataracts. Diabetes, steroids, and eye trauma could also lead to the earlier onset of cataracts.

Decisions
When cataracts start to interfere with your lifestyle, then you should consider surgery. Because cataract surgery has steadily improved over the past 20 years, the procedure presents minimal risk. So, it is reasonable to consider surgery as soon as cataracts start to diminish your quality of life. Previously, many people would put off or never have cataract surgery and simply accept the vision loss as a part of the aging process but that is no longer necessary.    
Surgery
Picture a grape. The surgeon tears a tiny whole in the outside “skin” and then sucks out the “fruit.”  In essence, the surgeon is sucking out all the abnormal protein.  However it is hardened and the surgeon has to crack it up into small pieces to get it out.

In addition, the surgeon will implant an artificial lens in the “skin” that holds the natural lens. Most cataract surgery uses this option. In a few cases, the doctor may not be able to replace the lens. After your eye has recovered from surgery, you will be fitted with eyeglasses or contact lenses to compensate for any residual focusing issues.

Safety
Overall, less than 1% of people develop a serious complication after cataract surgery. The risk of blindness after surgery is very low. While relatively uncommon, potential complications include swelling of the retina, new or different astigmatism, inflammation of the cornea, retinal detachment and infection.

Advances
Femtosecond laser assisted surgery is the most advanced method of cataract surgery.  While introduced about a year ago and only available in only a few areas of the country, this groundbreaking technology is already being used in the western suburbs. Elmhurst Outpatient Surgery Center is now using the Catalys™ Precision Laser System for cataract surgery and astigmatic correction.  The system’s state-of-the-art femtosecond laser, advanced 3D Optical Coherence Tomography (OCT) imaging, sophisticated software and a host of other unique features enable surgeons to provide a gentle, highly customized procedure with unprecedented precision.

Such technology eliminates the manual steps of using a surgical blade, bent needle, forceps or chopper by using a laser to pretreat the eye prior to surgery.  This adds greater precision to the cataract procedure potentially making the surgery safer.  With the laser procedure, the surgeon creates small curved incisions in the cornea at a precise depth, length, location and angle to tackle astigmatism.  Instead of manually applying pressure to make a cut in the “skin of the grape,” the laser makes a perfectly round cut. The laser then breaks up the protein inner core into tiny cubes, making it possible to gently remove the cataracts. Clinical studies have shown that this opening is approximately ten times more accurate when performed with a femtosecond laser than what is achievable by hand.

The result: Improved precision – and improved safety, since there is less energy put into the patient’s eye.  As such, patients experience:

·         Little or no discomfort

·         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 could reduce the need for glasses or contacts after surgery

About the Author
Dr. Balaji Gupta is one of the ophthalmologists who uses the Catalys femtosecond laser to perform cataract surgery at Elmhurst Outpatient Surgery Center (www.eosc.org), one of the first healthcare facilities in Illinois to offer the advanced procedure. Dr. Gupta practices at DuPage Ophthalmology (www.dupage2020.com) in Lombard, IL.

About Elmhurst Outpatient Surgery Center
Elmhurst Outpatient Surgery Center is a multi-specialty center performing more than 8,000 procedures annually in Elmhurst. Elmhurst Outpatient Surgery Center has been serving the communities within DuPage, Cook, Will, Kane and other surrounding counties since 1999. For more information, visit www.eosc.org.