Cataract Surgery

 
Middle aged couple with coffee

Years ago the only goal of cataract surgery was to improve vision. However, there have been so many surgical advances in the last 30 years, that this goal is now achieved approximately 99% of the time in a skilled surgeons hands. So Ophthalmologists then began to look at how can we make the procedure better.

  • What else can we do to improve our patients lives after cataract surgery?
  • How can we make the procedure safer, the outcomes more predictable and the post surgical recovery of vision faster and smoother?
  • Finally, can we also eliminate the need for eyeglasses or contact lenses after cataract surgery?

Happily, the answer to all those questions is now a resounding yes!

One of the greatest new advances in cataract surgery is the use of the femtosecond laser to assist the surgeon. The laser replaces the hand held scalpel making incisions with a degree of accuracy and precision that is impossible to achieve by hand. Additionally, the laser breaks up the cataract lens making the subsequent removal of it much less traumatic to the delicate inner tissues of the eye. Finally, the laser is used to reshape the cornea, the clear dome over the front of the eye, eliminating any irregularities (astigmatism) which are causing blurred vision. The result of all this is a lower complication rate, faster recovery of vision and better vision without glasses than can be achieved when the surgery is done manually. Unfortunately most medical insurance companies are not willing to pay for this advanced technology. Their goal is just to pay for the minimum despite the obvious advantages of the laser. However, Dr. Corwin strongly believes that in his hands, Femtosecond laser assisted cataract surgery gives better results and he recommends it to almost all of his patients unless there is a contraindication to its use.

When the cataract lens is removed, it must be replaced with an artificial plastic lens called an intraocular lens implant (IOL). This lens is about a third of the size of a dime and stays in the eye forever. It does not wear out and never needs to be replaced. You cannot feel it nor rub it out like a contact lens.

Cataract Symptom Checker

Cataract Surgery Technology

LenSx® Cataract Surgery

LenSx System

The LenSx® laser is an advanced, precision-based technology that operates with unmatched precisions and computer-control, helping ophthalmologists to customize the procedure to your eye. It is a technologically advanced option for cataract patients.

When you choose the LenSx® laser, you’ll enjoy a range of vital benefits. A custom-tailored solution for your eyes.

While all human eyes share the same basic anatomical structure, every eye is just a bit different in terms of size, depth, the curvature of the cornea, and other key features. Which is why every eye must be carefully measured and mapped prior to cataract surgery.

The LenSx® laser uses a range of highly advanced technologies – including integrated optical coherence tomography (OCT) – to capture incredibly precise, high-resolution images of your eyes.

These images – and the measurements and data they provide – are then used to plan and perform surgery to exacting specifications not attainable with traditional surgery.

LenSx allows the cataract specialist to make all laser incisions. No blades are used. The LenSx® laser performs several of the most critical steps of the surgical process with an image-guided femtosecond laser.

ORA Cataract Surgery

ORA guides the use of Advanced Technology Lenses by allowing your cataract surgeon to ensure the lens is perfectly selected and placed which helps give patients a better visual outcome.

During the procedure, your eye specialist can take measurements of your eye allowing adjustments to be made to optimize visual outcomes.

There are now 3 different types of lens implants.

Multi-Focal IOL:

If you would love to no longer wear any eyeglasses after cataract surgery, you should choose a “Multifocal” lens implant. This lens will give you excellent vision at all distances after your cataract surgery. If you want to enjoy the freedom to play golf or tennis, swim or play with your grandchildren without eyeglasses getting in your way then this is the lens for you. Women, perhaps you are having difficulty seeing well enough to put on your eye makeup but obviously you can’t wear eyeglasses when you do this? A Multifocal IOL also can solve this problem. However, we cannot use this implant in every eye. Extensive diagnostic testing must be done beforehand to be sure you are a good candidate for it. Also, when using this implant, you should have the procedure done using the femtosecond laser in order to achieve the level of precision necessary for this lens to function properly.

Basic IOL

The second type of lens implant is called the “basic” implant. You will achieve improved vision with this lens but will still be dependent on eyeglasses most of the time. If the basic implant is combined with the femtosecond laser, usually you will only need eyeglasses to read afterwards. If you don’t mind wearing eyeglasses then the Basic IOL is the one you should choose.

Toric IOL

The third type of implant is called a “Toric” implant and is not for everyone. It is only used when the eye has a very irregular corneal shape causing a large degree of astigmatism. Toric lenses are available in either “basic” or “Multifocal” versions. If you have a high degree of astigmatism your vision after surgery will be much better if you use the Toric intraocular lens.

Dr. Corwin answers your questions about cataracts

Behind the pupil or the colored part of your eye lies the lens. Similar to a camera lens, this is what focuses everything you are looking at. When you are young, the lens is crystal clear but as you age the lens becomes cloudy. When that happens to the lens we call it a cataract. It is important to understand that a cataract is not a disease but rather an inevitable part of the aging process, similar to your hair turning gray. If you live long enough, everyone will eventually develop cataracts.

In the earlier stages of a cataract the answer is yes. However, when the lens reaches a certain level of cloudiness, unfortunately eyeglasses will no longer help you see better. If you were looking through a dirty window, no power of eyeglasses would help you see perfectly clearly through it. Similarly, no matter what prescription lens you put in front of your eye, you still would have to look through the cloudy cataract lens and therefore your vision will not be clear. When you start to notice your vision is no longer clear enough to satisfy you and eyeglasses cannot improve the vision further, then is the time to consider cataract surgery.

While only an exam by your eye doctor can definitively confirm whether or not you have a cataract, there are a few symptoms you may notice yourself. Glare around oncoming headlights and street lamps at night is a common sign of cataracts. Or maybe you are noticing more difficulty seeing street signs in unfamiliar neighborhoods. Do you find yourself constantly cleaning your spectacle lenses to try and see better? However, since cataracts develop slowly over years, you may not notice your vision worsening until you are seen by the doctor and notice you can no longer read the bottom few lines on the eye chart. Although nobody relishes the idea of having surgery, the good news is that nowadays cataract surgery is a quick and painless surgery with no pain, quick recovery and excellent results. Additionally, modern cataract surgery can also reduce or sometimes even eliminate the need for eyeglasses even if you have worn them for years and years. Now isn’t that a nice thought?

The procedure is done in our state certified surgery center devoted exclusively to eye surgery. The cataract lens is broken up into microscopic pieces using ultrasound called phacoemulsification and then the pieces are suctioned out of the eye. A small plastic lens called an intraocular lens implant [IOL) is inserted back into the eye to replace the natural lens. An IOL is about a quarter of the size of a dime and will stay in your eye forever. You will be unable to feel it or rub it out. It never wears out nor ever needs to be replaced. The surgery itself should take less than 15 minutes and your eye is numbed with anesthetic eyedrops so you should not have any pain at all. Also you will be given a sedative medication so that you will be very relaxed and drift in and out of sleep during the surgery. You probably won’t remember much if anything of what happens.

Yes, there are 3 different types. A “standard” IOL will improve your vision although you will still most likely need eyeglasses or contact lenses to see your best after the procedure. A “toric” IOL is used when a patient with a cataract also has high degrees of astigmatism, an irregularity in the shape of the clear dome over the front of the eye called the cornea. Finally a “Multifocal” IOL acts like a bifocal in that after implanted, the patient will be able to see well at both distance and near without eyeglasses.

The newest technology, a femtosecond laser is used to perform many of the steps in the procedure that were previously done with hand held micro instruments. The laser is able to achieve a level of precision, accuracy and safety that cannot be achieved manually, even in the best surgeons hands. It also can be used to correct lower levels of astigmatism, thus reducing your dependence on prescription eyeglasses after surgery.

You will be sent home with a clear plastic shield covering your surgical eye. The eye may feel a bit scratchy for a few hours but pain is extremely rare. The next morning you will see me in our office. Although many patients notice a huge improvement in vision by the very next morning, it usually takes a few days to weeks for you to achieve your best possible vision. You will be instructed to wear the plastic shield just at bedtime and also avoid swimming or very heavy lifting for the first week. After that there are no restrictions. You will also be using prescription eyedrops for approximately 4 weeks. You can usually return to work the day after your surgery.

If you think you have cataracts, been told you have cataracts or the self assessment test below indicates that may be a possibility, we encourage you to schedule an appointment. We will do extensive testing to let you know if that is the case or if there is something more serious going on that is causing your symptoms. Remember, blurred vision may also be due to something as benign as just needing a new eyeglasses prescription. A cataract evaluation exam is covered by both your medical insurance and your vision insurance.

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Thousand Oaks

351 E. Rolling Oaks Drive Suite 102
Thousand Oaks, CA 91361

Phone: 805.497.3744
Fax: 805.497.1663
OfficeHours:
Monday- Friday: 8:00 am - 5:00 pm

Simi Valley

2045 Royal Avenue Suite 125
Simi Valley, CA 93065

Phone: 805.527.6720
Fax: 805.527.1889
OfficeHours:
Monday- Friday: 8:00 am - 5:00 pm

Agoura Hills

28040 Dorothy Drive Suite 103 Agoura Hills, CA 91301

Phone: 818.889.2020
Fax: 818.706.0288
Office Hours:
Monday-Friday: 9:00 am - 5:00 pm
Saturday: 8:15 am - 12:00 pm, except Holidays