Our Focus is Your Vision
A cataract is a clouding or discoloration of the eye's lens. When a cataract is removed, the surgeon is actually removing the natural lens of the eye. After the cataract is removed, the surgeon places an artificial lens into the eye to help it focus. This is called an intraocular lens implant (most often simply referred to as an "implant"). Implants have become the standard of care and they are placed in all cataract patients unless there is some unusual reason an implant cannot be used. Choosing the right implant can make all the difference in the world regarding the patients visual outcome.
The Eye MDs offers Zeiss IOL Master Technology, which provides extremely accurate measurement of the eye and multiple implant calculations to enable our physicians to select the best implant power for each individual. This helps our doctors provide customized cataract surgery, as every eye has specific optical requirements to optimize vision.
Years ago, before implants were used, patients had to wear very strong glasses or even contact lenses after cataract surgery. This is because the eye was left without any lens and all of the focusing had to be done with glasses or contacts. Without these visual aids, the patient would be legally blind. Implants were introduced decades ago. Implant function and safety in the eye has improves steadily over time.
Implants now provide most of the focusing power for the patient’s eye. Implant materials and designs have evolved over time. For many years, implants were made of solid pieces of plastic called PMMA. The cataract incision had to be at least as big as the implant as it was inflexible. The common size for these rigid lenses today would be 5.5 to 6.0 mm. A cataract incision of this size usually requires stitches to be water tight.
Over the past few decades, foldable implants have gained popularity as they can be placed into the eye through a much smaller incision. These implants have flexible optic lenses made of acrylic or solid silicone. They can be placed into the eye through a self-sealing incision as small as 1/8th of an inch. Sutures are not usually required due to the small size of the incision and its self-sealing design. These small foldable implants also enable the surgeon to perform topical cataract surgery eliminating needle injections, patches and shields.
The foldable implant enables the surgeon to use a very small incision. Through the small incision, the cataract is broken apart with an ultrasound device and gently vacuumed from the eye. These small incisions do not induce significant changes in the patient’s astigmatism seen with larger incisions of the past, thus results are more predictable. With such predictable outcomes, the surgeon can consider special corneal incisions or advanced astigmatism-correcting implants (called Toric implants) to reduce significant pre-existing astigmatism. These astigmatic corrections are done at the time of surgery and can often enable patients with significant astigmatism to enjoy an astigmatic reduction after cataract surgery (not all patients benefit by astigmatic incisions). Reduction in astigmatism reduces the patient’s need for glasses to correct their vision. This new technology simply reduces dependency on glasses for many daily activities (it does not necessarily eliminate the need for glasses in all situations).
Many patients with basic single-focus implants (e.g., basic implants and Toric astigmatism-correcting implants) can see well enough to get around without glasses; some see extremely well in the distance without glasses. Glasses are still needed by the majority of patients with basic implants to read and to provide their very best, full range of vision.
Over the past several years, Advanced Technology Implants have been developed that provide a wider range of focus after cataract surgery to include distant, intermediate and even some near vision; thus reducing dependency on glasses after cataract surgery.
The focusing (also called accommodating) implants provide a fuller range of vision compared to a basic implant with one set point of focus. This range of vision better mimics the natural human eye. These new Advanced Technology IOLs can provide distant, intermediate and near vision thus reducing dependency on glasses. The Advanced Technology Implants are small and foldable but have the added advantage of focusing distant and near.