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Treatments
With early cataracts, a change in glasses may help for a period of time. The mainstay of treatment, however, is still surgery. Contrary to popular belief, cataracts cannot be cured by drops, pills or laser surgery. A laser is commonly used after cataract surgery to clear away a secondary film that may develop.
The modern surgical technique involves making a small cut along the side of the eye and introducing a small specialized cannula into the eye. This "phacoemulsification" unit uses high frequency ultrasound to break up the lens and a fluid vacuum system to remove the fragments. The lens capsule is left intact to provide a natural pocket for the artificial lens implant.
When the eye's natural lens is removed, it is left in an optically weakened state. In order to recover this loss of power to bring things into focus, an artificial lens is implanted at the time of surgery. Lens implants were first developed fifty years ago by the British ophthalmologist, Dr. Harold Ridley. While treating eye injuries in WWII pilots, Ridley noticed that penetrating acrylic fragments from airplane canopies did not incite inflammation inside the eye. This same material was later used in the first implants. Since that time, there has been a revolution in lens implant designs and materials. Modern implants are made from flexible material that allows them to be folded and inserted through a small "no-stitch" incision. Lens implants are designed with an optical component (the lens) and fixating loops or plates. Optical components are now being developed with the ability to correct astigmatism.
The decision to proceed with surgery is ultimately made by the patient, and is based on how much the cataract is interfering with daily activities. After a complete eye examination, measurements are taken to calculate the appropriate power for the lens implant. The goal of the lens implant selection is to reduce the requirement for glasses after surgery. The surgery itself is usually a short procedure performed with a small dose of intravenous tranquilizer. The eye itself may be frozen with drops or by an injection made along side it. With the small incision technique, a patch is not worn after surgery and patients return to their normal activities immediately. Eye drops are taken for one to two months.
Today, cataract surgery is highly successful with very few complications. However, we must not forget that it is still surgery and may have complications. Your surgeon will review these complications with you prior to surgery.
Some complications include:
- Retinal tear or detachment
- Endophthalmitis (internal eye infection)
- Retained lens fragments (incomplete removal)
- Cystoid macular edema (swelling in the retina)
- Chronic inflammation
- Capsular clouding requiring laser (up to 50% over time)
- Night glare
Remember a cataract is NOT:
- A film on the surface of the eye
- Caused by straining
- Reduced with drops or pills
- Treated with laser
- Something that has to be "ripe" before being treated
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