Cataract Surgery

Cataracts

Cataracts occur when the lens of your eye, which is normally clear, becomes cloudy or opaque.  Light that passes through the lens becomes scattered and diffuse, leading to blurred vision and nearsightedness.  The eye may also become more light sensitive and colors may looks faded.

Cataracts can result from a number of reasons, but there is no single cause for cataract formation.  Injury and trauma to the eye can cause cloudiness to form in the lens as part of the repair process.  Prolonged exposure to ultraviolet light can cause darkening of the lens, contributing to cataract formation during old age.  Diseases such as diabetes and hypothyroidism have also been strongly linked to cataracts, making regular eye exams important for anyone diagnosed with such conditions. 

Cataracts are initially treated by changing the prescription of glasses or contact lenses.  When this correction becomes insufficient to allow a normal lifestyle, cataract surgery is recommended.  During surgery, the doctor creates a micro-incision in the surface of the eye.  The lens containing the cataract is then broken down and removed, and an intraocular lens (IOL) is implanted in its place.  These artificial lenses can correct for a person's nearsightedness and/or astigmatism, depending on the type of IOL, and often provide excellent vision in the post-surgical eye.  Different types of lenses may be available depending on your eye's characteristics and are outlined below.

Cataract surgery normally takes about 20 minutes to complete.  With his experience doing thousands of cataract surgeries, Dr. Essepian has lowered his average time to about 7 minutes.  Patients can expect to be back to normal activity by that afternoon or the next day.  Please note, however, that the vision in the surgical eye will change in the following weeks as the eye adjusts to the IOL.  Some sensitivity to light and scratchiness of the eye is normal after the surgery, and can last several weeks.  To minimize the chance of infection and discomfort, patients will use a topical antibiotic (eye drops) the morning of the surgery and in the week following, as well as steroid anti-inflammatory eye drops for four weeks. Follow up visits are scheduled for the next day, and again after two weeks.  An additional anti-inflammatory eye drop may be prescribed depending on your medical history.

Intraocular Lenses

When a cataract becomes mature enough to impede daily life, the prevailing surgical option is to remove the natural lens in exchange for an artificial intraocular lens (IOL).  Modern IOLs not only replace the natural lens' functions, but can correct for existing nearsightedness, farsightedness, and astigmatism, eliminating the need for glasses and contacts in many patients.  Several different types of IOLs are available, but may not be prescribed depending on each patient's circumstances.  We use Alcon brand lenses for the vast majority of our IOL implants, a summary of which can be found in this PDF.

Monofocal Lens: The standard type of IOL, a monofocal lens corrects for nearsightedness or farsightedness.  Patients who have a monofocal IOL typically experience clear distance vision and can drive without correction, but often require glasses for reading or computer work.  The vast majority of insurance plans will only cover the cost of a monofocal lens.

Multifocal Lens: Multifocal lens are capable of correcting near, intermediate, and distance vision, employing the use of multiple focal points with tapered transitions between each "level" of the lens.  While multifocal lenses, such as the AcrySof Restor, are not covered by insurance and will therefore require an additional payment from the patient, they represent the best chance of enjoying day to day life without glasses or contacts.

Toric Lens: Like a multifocal lens, a toric lens is a premium IOL that is not covered by insurance, but has the singular potential to compensate for pre-existing astigmatism in patients.  With the astigmatism corrected, patients can often go without any glasses for distance vision and driving, but will need glasses for reading or computer work.