Cataract Surgery

Below are some commonly asked questions regarding surgery to treat cataracts.

What is a cataract?

The human eye contains a lens, much like the lens of a camera. It is located just behind the iris (the colored part of the eye) and its function is to focus light rays onto the retina, the sensitive membrane at the back of the eye. This lens must remain clear for the light to pass through. When the lens becomes cloudy, it is called a cataract. In other words, the cataract is not a growth or a film over the eye. It is the natural lens of the eye that has become cloudy.

What are the signs of a cataract?

Cataracts do not cause any pain or redness of the eye. In the early stages of cataract development, vision is slightly blurred with occasional fluctuations. As the cataract progresses, the prescription of the eyeglasses may change; some patients become more nearsighted and some experience an improvement in their farsightedness. This is due to changes within the lens that make it refract the light slightly more forward than it used to do before. The vision decreases with time.

What causes a cataract?

Most often a cataract occurs as a natural part of the aging process, like the graying of the hair. In younger patients, it sometimes results from injury, diabetes, long-standing inflammation within the eye or from certain drugs.

Can I prevent cataract progression?

A cataract may develop rapidly over a period of a few months or it may progress very slowly over several years and there is no known medical therapy for this condition. In younger patients, a balanced diet and cessation from cigarette smoking have been found to delay cataract development.

Research continues in the area of the ultraviolet light exposure that may contribute to the rapid development of certain types of cataract. Ultraviolet absorbing glasses are now available from most opticians.

What is the treatment of a cataract?

The treatment of a cataract is the surgical removal of the cloudy lens and replacing it with a clear plastic lens, called a “lens implant”. The time for cataract surgery can vary with the degree of impaired vision and how it handicaps the individual patient's lifestyle. Someone who leads an active life and relies a great deal on the eyes for reading or driving will need cataract removal at a much earlier stage than someone with less critical visual needs.

The decision for surgery is made by the ophthalmologist in consultation with the patient. When cataracts are left in the eye long past the stage of blindness, they can cause inflammation and glaucoma. With our present methods of cataract removal, the operation can be performed at any stage of development with a high rate of success.

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About the Surgery

Scheduling the Surgery

Once the decision for surgery has been made, the patient will have a special teaching session on what to expect before, during, and after the surgery, and to make sure that all the questions are answered. Family members are welcome to attend too. An informed consent has to be read and signed by the patient indicating that he or she understands the options regarding the procedure and the possible complications.

Tests Performed Before Surgery

An ultrasound exam measures the precise dimensions of the eye and a computer is used to determine the actual power of the intraocular lens needed for surgery. A pertinent system review (mainly about the presence of high blood pressure, diabetes or heart disease) and blood pressure check will be performed to determine the general condition of the health.

The Day of Surgery

Before the surgery, the patient should not eat or drink for at least 8 hours. Medication regimens will vary: Heart and blood pressure medications are taken as usual with a sip of water; Insulin or other diabetic medications are delayed till after the surgery; Aspirin and other anticoagulants are discontinued for 3 days prior to surgery after consultation with the Primary Care Physician.

The patient is instructed to report to the center at a certain time and is ushered to the surgical reception area for preparation. The nurse in charge will then apply anesthetic, antibiotic and dilating eye drops. Once ready, the patient is taken to the Operating Room. Most patients are operated under local anesthesia. The heart, blood pressure, pulse and respiration are monitored by the anesthesiologist who administers medications to insure painless surgery.

Having the Surgery at M/S Surgery Center

Our M/S Surgery Center is the first of its kind in Southern California. It is approved by the United States Department of Health and Human Services, the State of California, Medicare, Medi-Cal and most private insurance companies. With today's technological advances, cataract surgery is now performed in our Center without hospitalization or any overnight stay. After a short recovery period, patients can walk to the car and be allowed to recover in the privacy of their own home.

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The Surgical Technique

Cataract Removal

The most commonly used technique to remove the cataract is called Phacoemulsification. Essentially, through a very small incision, the cataract is emulsified into small pieces using high frequency ultrasound. It is then aspirated from the eye leaving behind a very thin capsule, about the thickness of Saran Wrap. This protective membrane of the lens capsule prevents the vitreous from moving forward through the pupil. A number of serious complications can be avoided in this manner.

Phaco Surgery	IOL in place

Lens Implant

After that the cloudy lens is extracted, the eye can no longer focus on its own since this was the function of the lens that was removed. In the old days, the focusing power of the eye was restored with either thick cataract spectacles or the use of contact lenses. Nowadays, these two methods of correcting the vision after cataract surgery are rarely used. The most natural way to restore vision is by implanting an intraocular lens (IOL). The implanted lens is placed in the same position within the eye as the natural lens. An IOL requires no care, remains in the eye permanently, and is not felt by the patient. With the correct implant, pre-existing nearsightedness or farsightedness can be reduced. The tiny implant gives clear vision but it can not vary its focus to give clear vision at all distances. Patients usually need regular eyeglasses to obtain the best possible vision for far and/or for near.

Decrease your dependence on glasses after cataract surgery: Download this brochure to learn about the new toric lenses and ReStor® Bifocal Lenses.

Click here for our cataract video.

The Laser Treatment

Sometimes, patients refer to cataract surgery as a "laser surgery". Although research is under way to develop special probes to remove the cataract with a laser beam, it has not been perfectioned yet. At present, laser treatment does not replace the surgical intervention. It is used to open the capsular membrane left in place after the surgery. The painless laser procedure is done under topical anesthesia (eye drops) and is not used routinely on every case. The need for a laser treatment is determined by the ophthalmologist.

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Are there any complications?

It is important to understand that no surgical procedure is perfect and occasional complications can occur during or after the surgery. These are relatively rare, and when they do occur, the conditions can usually be corrected.

What to expect after surgery

Patients who have this very delicate microsurgical operation experience a relatively easy postoperative period. Anti-inflammatory and antibiotic eye drops are prescribed to promote fast healing of the operated eye. The first week after the surgery, patients should avoid doing anything that creates a physical strain. In general, it is no problem if activities are kept in moderation. Patients can bathe and shower normally but should avoid getting soapy water in the eye. Also the first week, the operated eye is very sensitive to light. Sunglasses or ultraviolet filtering goggles can be used after surgery for protection during the day. A protective eye shield is usually provided to cover and protect the eye during sleep. Most regular activities can be resumed after one week. New glasses are usually prescribed six to eight weeks after the surgery.

Conclusions

Decrease your dependence on glasses after cataract surgery: Download this brochure to learn about the new toric lenses and ReStor® Bifocal Lenses.

Click here for our cataract video.

No person should suffer blindness because of a cataract. Due to advances in modern surgical techniques, intraocular lens design, and laser devices, a cataract surgery has become a safe procedure with a swift return of vision in most cases.

The rate of success exceeds 98% if the back of the eye is not damaged by diabetes, high blood pressure, macular degeneration, glaucoma or any other systemic disease.

The eye surgeons at the Shammas Eye Medical Center are experts in cataract surgery. They perform over 1200 surgeries every year at M/S Surgery Center. The Center is equipped with state-of-the art phacoemulsification and laser units to ensure the best results ever. M/S Surgery Center and the Shammas Eye Medical Center are dedicated to make the process a smooth one for you. Our nurses will fill all the necessary forms, will obtain authorization from your insurance company and will call you to schedule the surgery at your convenience.

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