Early cataract symptoms may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses or magnifying lenses. If these do not help and vision loss interferes with everyday activities such as driving, reading or watching television, cataract surgery is the only effective treatment. You and your Wolfe Eye Clinic doctor can make this decision together.
Modern surgical techniques have made cataract removal one of the safest and most successful surgeries today. The virtually painless procedure takes about 20 minutes and is usually performed in a hospital or surgery center on an outpatient basis. Cataract surgery is performed with the surgeon looking through an operating microscope. The clouded natural lens is dissolved by a process called phacoemulsification. The lens is then replaced with a plastic intraocular lens (IOL). This is accomplished through a tiny incision in the eye that often heals on its own and does not require stitches.
The IOL’s most commonly used over the last 50 years are called monofocal IOLs because they have the ability to provide only one best focal point. With monofocal IOLs, patients need to choose whether they want their best vision (without glasses) to be in the distance or near. Many people pick distance focus monofocal IOLs so they can perform distance type activities without absolutely needing glasses. These people will need to wear reading glasses for near activities. Some people, usually those who have been nearsighted all their life, want to remain nearsighted and select the near focus monofocal IOL. These people will need to wear glasses to see clearly in the distance.
About half of the population is born with corneas that are shaped in a way which create astigmatism. Glasses or contact lenses are needed to correct astigmatism. In 2007, a new style of IOL was introduced. The toric IOL can correct, or at least partially correct naturally occurring astigmatism so you won’t be so dependent on glasses to see in the distance after cataract surgery. Many patients with astigmatism qualify for this IOL because the eye does not need to be perfect in every other way for this type of cataract technology to be effective.
Presbyopia is a part of the normal aging process and is caused by the loss of flexibility of the natural lens and the weakening of the lens’s focusing muscle. Presbyopia makes it difficult to focus on near objects. This generally begins around age 45, as we notice we can’t see well up close to read or see the computer. When this happens we have to start wearing reading glasses or need bifocal lenses.
Everyone who undergoes cataract surgery with a standard monofocal IOL needs to have reading glasses to see up close afterward (unless they are intentionally targeted to be nearsighted) because presbyopia is not treated by the standard monofocal IOL. In 2003, several IOLs were introduced which may correct presbyopia after cataract surgery. Patients who choose to receive a presbyopia-correcting IOL can usually reduce their reliance on glasses in both near and far vision. This option isn’t available to everyone because, in order for it to work properly, the eye’s anatomy must be virtually perfect in every other way.
Depending on the result of your examination, you may have the option to select between the monofocal, toric or presbyopia-correcting IOL. Depending on your choice, there may be additional out-of-pocket costs associated with these technologies. You and your doctor can discuss which option is best for you.
Laser-assisted Refractive Cataract Surgery
Laser-assisted refractive cataract surgery was introduced to Iowa by Wolfe Eye Clinic in 2012. This type of cataract technology adds computer and laser precision to some of the steps during cataract surgery, which can make the results even more consistent than that which can be obtained by even the most skilled surgeons. Through tiny laser created incisions in the cornea, it also adds the ability to reduce smaller amounts of astigmatism in order to fine-tune vision and achieve better results with monofocal, toric and presbyopia-correcting IOLs. Because of the equipment expense associated with the laser-assisted procedure, this surgery is currently only performed at Wolfe Surgery Center in West Des Moines.
Wolfe Eye Clinic offers expert care in presbyopia and full cataract treatment throughout Iowa, including Ames, Cedar Falls, Cedar Rapids, Des Moines, Fort Dodge, Iowa City, Marshalltown, Ottumwa, Spencer, Waterloo, and Pleasant Hill. Please contact Wolfe Eye Clinic at 1-800-542-7956 to ask any cataract-related questions or to schedule an appointment with one of our cataract specialists.