Cataract Surgery
What Is a Cataract?
A cataract is the clouding of the lens of the eye. The lens is located behind the iris (colored part of the eye). It is clear, soft, and flexible when we are young. This flexibility allows it to change shape to help us to focus for near vision. As we age, the lens stiffens and hardens and cannot change shape as well to focus up close. This is called presbyopia. To cope with this blurry near vision, we wear readers or use bifocals.
As we continue to age, the lens continues to harden and then it starts to become cloudy and we call it a ‘cataract’. The cloudiness prevents light from being properly focused on the retina. Cataracts are a normal part of aging. Most people will develop cataracts if they live long enough.
In the early stages, cataracts may not disturb vision. Cataracts slowly worsen with time and eventually result in blurry vision, difficulty reading, and driving at night. They may cause sensitivity to light and glare. If they continue to become very advanced cataracts, the vision becomes even more blurry until it may appear as if one is looking through waxed paper.
Currently there is no pill or medical treatment to reverse or prevent cataracts. Once they become visually significant, cataract surgery is the only way to achieve clear vision again. Cataract surgery can be performed safely at the Grand Island Surgery Center on an outpatient basis.
Surgery
Cataract surgery is considered to be one of the safest and most successful procedures performed in medicine today. It involves making a tiny incision through which the cataract is removed and replaced with a clear intraocular lens. No stitches are required.
Intraocular Lenses
An intraocular lens (or IOL) is a tiny artificial lens used to replace the eye’s cloudy natural lens that is removed during cataract surgery. IOL’s are made of acrylic and come in different focusing powers, just like prescription glasses.
The day of your appointment for the cataract evaluation, the length of the eye and curve of the cornea will be measured to determine the IOL prescription that is best for your eye.
Types of Intraocular Lenses
Monofocal IOLs
The most common type of lens used with cataract is called a monofocal IOL. It has one focusing distance. It corrects nearsightedness or farsightedness but NOT astigmatism nor presbyopia. It can be set for distance or up close. Most people who choose this option for distance wear eyeglasses or reading glasses for near work.
It is covered by most insurance companies.
Multifocal IOLs
This lens implant has different focusing powers within the same lens. These help reduce your dependence on glasses by giving you clear vision at more than one distance. Another term for this lens is ‘presbyopia correcting IOL’.
These lenses are not covered by insurance companies and require an out-of-pocket payment. These implants may cause glare or halos at night and don’t work as well in dimly lit areas. These lenses are for patients who want to be independent from glasses for most activities.
Astigmatism
For patients with astigmatism where the curve of the cornea is shaped more like a football rather than a basketball, there are two surgical options which are also not covered by insurance companies.
- Limbal Relaxing Incisions may be used for small amounts of astigmatism. For this option, the surgeon makes small incisions on your cornea at the time of cataract surgery.
- The second is a toric intraocular lens. These lenses have extra built-in correction for astigmatism and are available in monofocal and multifocal IOLs.
If you choose not to surgically correct your astigmatism, glasses may be necessary for all distances.
Which IOL Should You Choose?
Not all of the IOL types are covered by insurance companies. Medicare and most insurance companies do cover the cost of the most common IOL, the monofocal lens. These lenses have been used for decades and are the most popular type because of insurance coverage. You will most likely need glasses for reading or distance with this type of lens. For patients who have enjoyed monovison in the past with their contacts or LASIK, they may choose to do monovision with the monofocal IOLs at no additional cost.
Toric and Multifocal IOLs are considered premium lenses and are offered to reduce the need for glasses or contact lenses. The ability to read and perform other tasks without glasses varies from person to person. They are more expensive than monofocals and usually are out of pocket. Gleason-Janky Eye Physicians offer these lenses for significantly less cost than other eye surgeons.
Glaucoma
If you have glaucoma, there are several surgical options that can be performed at the same time as the cataract surgery to improve your eye pressures. Some patients who are on 1 or 2 glaucoma drops may be able to stop their glaucoma drops after the surgery.
These options are covered by most insurance companies. Your surgeon will discuss these at the time of your cataract evaluation.