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Abdulfatah M. Ali, M.D.		  
 E. Randy Craven, M.D.		  
C. Starck Johnson, M.D. 		  
John Samples, M.D.

A cataract is an opacity that clouds the natural lens inside the eye.  Normally the path of light to the retina (where the light sensors are) is as clear as possible.  When proteins that make up the lens clump together, the resulting cataract blocks some of the light, making vision blurry or hazy.

 

Cataracts typically occur more frequently in the aging population, however there are many other factors such as family history, diabetes, long term UV exposure, or certain medications like steroids that can cause cataracts.  Also, previous eye injuries can be an attributing factor.

  CLICK HERE FOR A VIDEO ON CATARACTS

Cataract symptoms may include:

  • Blurry vision.
  • Lights seem too bright or have a “halo” effect.
  • Double vision in one eye.
  • Decreased night vision – sensitivity to glare from headlights.
  • Dull or fading colors.

Some people actually experience an improvement in their near vision during the beginning stages of a cataract.  Unfortunately, this effect goes away as the disease progresses.  Early on, a cataract may be treated with increased glasses or contact prescription.  Once the cataract begins to interfere with daily tasks such as reading and driving, surgery is the only remaining option.

Intraocular Lens (IOL)

Traditional IOLs are monofocal, meaning they offer vision at one distance only (far, intermediate or near). They are definitely an improvement over the cataractous lens that is replaced during surgery, which provides only cloudy, blurred vision at any distance. But traditional IOLs mean that you must wear eyeglasses or contact lenses in order to read, use a computer or view objects in the middle distance, especially if you are already experiencing presbyopia before cataract surgery.

  CLICK HERE FOR A VIDEO ON INTRAOCULAR LENS (IOL)

The new multifocal and accommodating IOLs offer the possibility of seeing well at more than one distance, without glasses or contacts. Here are a few examples:

AcrySof ReStor (Alcon) uses apodized diffractive technology — a design that responds to how wide or small the eye's pupil might be — to provide near, intermediate and distance vision. In early 2007, an aspheric version of the AcrySof Restor received FDA approval. Aspheric lenses, because they are somewhat flat near the edges, are thought to improve contrast sensitivity and provide better night vision than other types of multifocal IOLs.

Clinical studies used to support the March 2005 FDA approval showed that 80 percent of people who received the lens didn't use glasses for any activities after their cataract surgery; 84 percent who received the lens in both eyes had distance vision of 20/25 or better, with near vision of 20/32 or better.

Click Here to Learn More About the AcrySof Restor IOL

ReZoom (Advanced Medical Optics) is a multifocal refractive IOL that distributes light over five optical zones to provide near, intermediate and distance vision. The first version of this multifocal IOL was brought to the U.S. market in the late 1990s; the ReZoom is the second-generation version and was FDA-approved in March 2005

In a European study of 215 patients, 93 percent of ReZoom recipients reported never or only occasionally needing glasses.

Click Here to Learn More About the ReZoom IOL

Crystalens (Bausch & Lomb) gained FDA approval in late 2003, when the IOL was marketed by eyeonics. Bausch & Lomb acquired Crystalens in early 2008, and a newer version of the IOL, known as Crystalens HD, was FDA-approved in late June 2008. Crystalens was designed to restore the eye's accommodation ability, which is gradually reduced as presbyopia progresses. In FDA studies, about 80 percent of people who received the Crystalens HD could see at J2 or better (near vision equivalent of 20/20) after four months — superior to standard IOLs. As with multifocal IOLs, distance vision with the Crystalens tends to be very good.

"Accommodation" is the ability of the eyes to change focus from near to far, far to near and all distances in between. With presbyopia, which usually begins at around age 40, the eye muscle that accomplishes this accommodation — the ciliary muscle — has more difficulty in doing its job, because the eye's lens is becoming less flexible. The ciliary muscle contracts in its effort to move the lens forward, bending it slightly for closeup focusing; but the lens resists because it is not as flexible as it was when the eye was younger.

Since Crystalens has hinges on both sides of the IOL, it can be moved more easily by the ciliary muscle, allowing the eye to focus more naturally at a greater range of distances than traditional IOLs. So far, Crystalens is the only accommodating IOL that has been approved by the FDA, though others are in development.

Click Here to Learn More About the Crystalens IOL

Cataract Surgery

Cataract surgery is a very common procedure, and complications (if any) are rare and treatable.  The surgery itself is highly successful in improving the vision of patients about 95% of the time.  Cataract surgery is an outpatient procedure usually taking less than 30 minutes to complete.

During the surgery, the doctor removes the cloudy natural lens from the eye while the patient is under a topical anesthesia.  Next, the doctor inserts an intraocular lens (IOL), which remains permanently in place of the removed natural lens.  The IOL compensates for the magnification the old lens provided.  Modern IOLs are designed for various functions and made out of different materials; your doctor will know which is most appropriate for your individual case.  After the operation the doctor will apply a shield for the eye and provide you with eye drops to use as directed.

  CLICK HERE FOR A VIDEO ON CATARACT SURGERY

Recovery from Cataract Surgery

 

The patient may return home the day of the procedure.  With proper rest and avoidance of any strenuous activities such as heavy lifting, recovery is usually a matter of days, with only minor discomfort.  Several follow up appointments will be required to ensure the eye is healing properly and initial results are sustained.

Pseudoexfoliation and Exfoliation Capsular Tension Rings
 
Pseudoexfoliation is an ocular condition where a material that looks like dandruff comes off of the lens, inner iris (colored part of the eye), trabecular meshwork (drainage system), anterior chamber, zonules (suspension mechanisms for the lens) and ciliary processes (secretes fluid in the eye). The deposits can clog the drainage system of the eye, which causes an increase in eye pressure. This condition can also be associated with cataracts but more importantly it can loosen the zonule, which is the ligament that holds the lens.

If you are experiencing any symptoms of cataract problems, we encourage you to contact us today to schedule a consultation.

Specialty Eye Care Ophthalmologists, Abdulfatah M. Ali, M.D., E. Randy Craven, M.D., C. Starck Johnson M.D. and John Samples, M.D. - Locations in Denver and South Suburban area of Colorado. Cataract Definition, Symptoms and Surgery information.