What Are Cataracts?
You may not notice it very often, but your eyes are used for almost every single activity you perform throughout your day, everything from reading to driving to bird watching and playing golf. Throughout the life cycle, the proteins inside the lens of your eye may join together, turning the lens from clear to a cloudy color that will impair your vision.
There are certain behaviors that can put you at a higher risk for getting a cataract. Some of these may behaviors include:
- spending too much time in the sun without using proper eye protection
- being a regular smoker, or being near them frequently
- having high blood sugar
- using steroid medications
- having prolonged exposure to radiation
Cataracts start small, and initially they may only have a small effect on your vision. Things may seem a little blurry — like looking at a kaleidoscope or as if you were in an impressionist painting. The world may seem cloudy, blurry, or dim. These effects usually increase over time, until the patient becomes disoriented and in greater need of visual assistance.
As cataracts become more advanced, they begin to darken with a yellow or brown tinge. This gradual process begins to affect night vision and will make some activities like driving more difficult. In fact, a study from Curtin University in Australia found that treating cataracts reduced the risk of car accidents by 13 percent. If you suspect you have cataracts, be very careful at night and don’t drive when your vision is compromised.
The most common symptoms of a cataract are:
- Will likely experience cloudy or blurry vision
- Colors may seem to be faded
- Glare is present around lights
- Poor night vision
- Double vision (multiple images in one eye)
- Frequent prescription changes in contact lenses or eyewear
These symptoms also may be a sign of other eye problems as well. If you have any of these symptoms, check with your eye care professional in Shreveport today.
Statistics About Cataracts
Cataract surgery is the most common procedure performed by the ophthalmic surgeon. This year, 3.6 million cataract procedures will be performed in the United States and more than 20 million will be performed worldwide, according to estimates.
In the United States, there are approximately 18,000 ophthalmologists, of whom 9,000 perform cataract surgery regularly. Thus, a typical surgeon might anticipate a surgical volume of about 400 eyes per year.
Most cataracts are highly treatable. Cataract surgery is one of the most common surgeries performed in the United States, with approximately 98% of patients experiencing improved vision if there are no other eye conditions present.
50 million people are projected to have cataracts in the United States by the year 2050.
What Are The Different Types Of Cataracts?
There are three main types of cataracts, each describing different parts of the lens:
- posterior subcapsular cataracts
- nuclear cataracts (in the center of the lens)
- cortical cataracts( on the side of the lens, which appear as small streaks)
Those with nuclear cataracts may briefly see their vision improve over time as the body adjusts. This sensation is sometimes referred to as a “second sight.”
There are also four main ways to develop cataracts, outside of those simply related to aging:
- Secondary cataracts can form as a complication after surgery for other eye problems, such as glaucoma. Cataracts can also develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to heavy steroid use.
- Traumatic cataracts can develop after an eye injury, or even sometimes years later.
- Congenital cataracts may affect some babies who are born with the cataracts or develop them early in childhood, often in both eyes. These cataracts may be so small that they do not cause problems with vision. If they do, the lenses may need to be removed.
- Radiation cataracts can develop after exposure to some types of radiation.
How Cataract Surgery Is Performed
The role of lasers in the removal of cataracts has been unfolding for decades already in the United States. Femtosecond lasers have been widely adopted in ophthalmic surgery practices everywhere since 2001, and in the late 2000s, work began to develop advanced applications for the lasers in cataract surgery. The medical laser has also found other positive applications including the ability to make incisions in the cornea to treat certain types of astigmatism, thereby reducing the need for corrective eyewear.
The laser performs three key steps in the cataract surgery procedure:
- Corneal incisions
- Opening of the capsule containing the cataract
- Sectioning of the cataract into smaller pieces.
The laser performs these three steps with incredible precision, and this may be the primary factor in this technologically advanced field which reduces the need for these steps to be manually performed by the surgeon, thereby reducing errors and improving accuracy as well as costs.
Two very small incisions (one larger, approximately three millimeters, or one-tenth of an inch, and one smaller, approximately one millimeter, or one thirty-second of an inch) are made in the cornea, which is the transparent dome-shaped tissue that covers the front part of the eye. A viscous (thick, sticky, glue-like) material is injected into the front part of the eye to help maintain its shape during surgery. This viscous material is made from substances that occur naturally in the body. Because it is thick, this material will not leak out of the incisions during surgery. (Source)
Types of Cataract Procedures:
In 2008, the first laser-assisted cataract surgery was performed in Hungary. After later gaining the approval of the Food & Drug Administration, the first laser-assisted cataract surgery was performed in the United States in 2010. Since that time, it has been gaining popularity and is now widely accepted as the current trend in medical ophthalmology.
Traditional Cataract Surgery
Traditional cataract surgery, although still complex, is both safe and extremely effective. A surgeon will make a tiny incision in the side of the cornea to remove the clouded lens. Using a process called “phacoemulsification,” the surgeon will then insert a small probe into the eye. This device releases ultrasound waves that break up the lens so it is able to be suctioned out.
Using the same small incision, the surgeon will then insert the IOL into the eye. The incision is so tiny that it usually does not even require sutures, and the eye tissue is allowed to heal by itself. This procedure is typically done on an outpatient basis, lasting approximately 20 minutes, and generally results in a quick recovery time. Most people are back to normal activities fairly rapidly after traditional cataract surgery.
Laser-Assisted Cataract Surgery
Laser-assisted cataract surgery has been used to remove cataracts for at least the past decade in the United States. This procedure provides the same outcome as traditional cataract surgery, but it makes use of a different method because of the advanced instruments. The surgeon utilizes a femtosecond laser to break up the cataracts, then using special software to create a surgical plan with a 3-D image of the eye called OCT (optical coherence tomography). This surgical plan includes the location, depth, and length of the cataract in all dimensions. By using this unique map of the eye, with the settings created in the software, the femtosecond laser will actually create the incisions and assist in the cataract removal with greater precision than a surgeon is capable of.
Light energy from the laser causes disruption of tissue borders with minimal damage to nearby tissue. The old lens is removed, and then, the new lens is inserted. Recovery time is known to be comparable with traditional cataract surgery, while most patients experience clearer vision and can resume normal activities rapidly after laser-assisted cataract surgery.
After The Surgery
A postoperative regimen requires only a single drop when TriMoxi is injected—drugs like ILevro or Prolensa may be prescribed once per day before bedtime. NSAID medications will often be recommended for four to six weeks in routine cases, and eight to 12 weeks in high-risk cases, such as those with preexisting diabetes mellitus. Patients may require an ocular surface rehabilitation after surgery, followed up by long-term ocular surface maintenance.
For a few weeks after surgery, the doctor may tell the patient to use eye drops to help heal the eye and decrease the risk of infection. An eye shield or eyeglasses may be recommended to help protect the eyes while outdoors. Avoid rubbing or pressing on the eyes after surgery.
Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also a common side effect. The eye(s) may be sensitive to light and touch. If there is discomfort, a doctor may suggest immediate treatment. After a day or two, moderate discomfort should disappear.