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Cataract Surgery

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What is a Cataract?

The eye works similar to a camera. Light enters the eye through the pupil, passes through a lens which focuses the images onto the retina at the back of the eye. The natural lens of the eye is clear. A cataract is clouding of the transparent lens of the eye. Changing your glasses prescription cannot fix this cloudiness of the lens so even when you have the best possible glasses prescription, your vision appears blurry. Cataracts are the most common cause of blurred vision in those over the age of 50.

What causes cataracts?

The majority of the time, cataracts are a natural part of the aging process. They do not occur at the same time in everyone, just like any other age related changes. Occasionally, cataracts can form for other reasons. These include injury, diabetes, use of certain medications, birth defects, or from previous surgery of the eye.

How do I know if I may have a cataract?

Cataracts cause alterations in your vision. They do not cause pain, tearing, redness of your eyes, or irritation. They typically cause blurriness, haze, and/or increased problems with glare. Vision may be affected over a period of years or it may be months. Normally, the natural lens of the eye sits within the eye itself, so cataracts are diagnosed by your eye doctor when they examine your eye at the slit lamp, a special microscope for examining the eye. Cataracts do not cause pain and most often develop slowly over time, gradually blurring your vision. You may not notice this decrease in vision at first, but it will become increasingly evident when trying to do daily activities.

When should I have my cataracts removed?

The decision of when is the right time to remove your cataract varies from one person to the next. It is an elective cataract surgery, so because the cataract is not harmful to your eye in the vast majority of cases, nothing needs to be done unless you are noticing the effect of the cataract on your vision. Once a cataract begins to affect your activities of daily living, whether it be during reading, driving, work activities, or participating in one’s hobbies, then cataract surgery is a sensible option. The notion that a cataract must become “ripe” prior to surgery is somewhat of an idea of the past. With modern day techniques and advances, there is no reason to delay one’s surgery if it can improve your vision and thereby improve your quality of life.

How are cataracts removed?

Since the cataract is located within your eye, removal of the cataract requires surgery; it cannot be treated with laser or medicine. It is one of the most common and most successful surgeries performed in this country. All of our New Hampshire Ophthalmologists at Eyesight perform cataract surgery. If you are experiencing symptoms of cataract formation, schedule a complete eye examination with one of our Ophthalmologists who can discuss your condition and treatment options with you.

Chart Illustrating the Cataract Surgery Process

How does cataract surgery work?

The goal of cataract surgery is to remove the cloudy lens and replace it with a clear artificial lens implant to restore your vision. Cataract surgery is performed on an outpatient basis in a hospital or surgery center. Depending on the case, patients are given a local anesthetic as well as a light sedation to make them feel relaxed during the surgery. Ultrasound is used to break up the cloudy lens (cataract) into tiny pieces which are removed through a small incision. An artificial lens is used to replace the cataract. This artificial lens is specifically selected based on the characteristics of the patient’s eye so that it will direct the light onto the retina at the back of the eye. Typically, the procedure takes less than 30 minutes. Patients return home the same day and can resume their usual activities within a few days. Your New Hampshire cataract surgeon will explain this entire process prior to surgery and provide all of the after surgery details necessary for a healthy recovery.

Special lenses

There has never been a better time to have cataract surgery. There are now advancements in lens technologies available which can allow patients to see clearly at multiple distances. These are called Multifocal Lenses and often times reduce the need for reading glasses.

There are also special lenses for people with significant astigmatism. This helps patients with corneal astigmatism achieve the sharpest vision after cataract surgery and may eliminate the need for glasses to correct any residual astigmatism after surgery. Our New Hampshire Cataract Surgeons will be happy to discuss special lenses and what they can do to help your vision after cataract surgery.

Questions about Cataract Eye Surgery

The following information answers questions that we frequently hear from our patients about cataract eye surgery. For more information, please contact our New Hampshire cataract surgeons.

At first, it’s hard to tell. You’ll notice some deterioration of your vision, such as more sensitivity to lights at night, colors look less vivid and bright, double vision, or some blurriness. Initially, a new glasses or contact lens prescription might help, but at some point, cataract surgery may become necessary.

Yes. Cataract types include:

Cataracts that affect the center of the lens (nuclear cataracts). A nuclear cataract may at first cause you to become more nearsighted or even experience a temporary improvement in your reading vision. But with time, the lens gradually turns more densely yellow and further clouds your vision.

As the cataract slowly progresses, the lens may even turn brown. Advanced yellowing or browning of the lens can lead to difficulty distinguishing between shades of color.

Cataracts that affect the edges of the lens (cortical cataracts). A cortical cataract begins as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex.

As it slowly progresses, the streaks extend to the center and interfere with light passing through the center of the lens. People with cortical cataracts often experience problems with glare.

Cataracts that affect the back of the lens (posterior subcapsular cataracts). A posterior subcapsular cataract starts as a small, opaque area that usually forms near the back of the lens, right in the path of light on its way to the retina.

A posterior subcapsular cataract often interferes with your reading vision, reduces your vision in bright light, and causes glare or halos around lights at night.

The causes cannot be clearly defined bu studies suggest some risk factors include:

  • Diabetes
  • Prolonged use of steroids
  • Prolonged exposure to ultraviolet light (sunlight)
  • Exposure to cosmic radiation
  • Over-consumption of alcohol
  • Prolonged exposure to air pollution
  • Exposure to lead

No. Advancing age is certainly a predisposing factor, and by the age of 75 or so, nearly everyone is said to have at least the beginning of a cataract. However, some babies are born with congenital cataracts, some apparently inherited, and others, are the result of the mother having an infectious disease while pregnant, such as chickenpox or German measles. Young healthy patients can also develop cataracts as stated above.

All surgery carries some risk, and cataract surgery is no exception. However, cataract eye surgery is the most commonly performed procedure in the United States., and if you choose an experienced cataract eye surgeon, risk can be minimal. Our New Hampshire cataract surgery experts help to minimize risk with their experience and bring a superior level of patient comfort to the overall cataract surgery experience.

Most commonly the lens is removed with a technique called “phacoemulsification” using a combination of ultrasound and aspiration to remove the cloudy lens rather than a laser. Also, after some cataract surgeries, the membrane that encloses the eye’s lens may become cloudy after the lens is removed. In these cases, a laser can be used to make a clear opening in that membrane, so that vision isn’t impeded.

The second surgery can be performed one day after the first surgery, but we prefer to wait at least a week to ensure the first operative eye is healing well.

We will be taking a number of measurements of your eyes. These measurements enable us to measure your unique eye and its characteristics. Contacts specifically alter the shape of your corneal curvature thus altering these measurements. It is important that patients follow these guidelines for contact lens removal prior to their diagnostic evaluation and surgery:

  • Soft contact lenses – remove them 5 to 7 days prior to your appointment
  • Toric or Soft Astigmatism correcting lenses- remove them for 2 weeks prior to your appointment
  • Hard contact lenses -remove them about 8 weeks prior to your appointment.
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