Modern Cataract Surgery

Cataract Surgery: The Basics

Cataracts are a common eye disorder in which the natural crystalline lens in the eye becomes cloudy and disrupts vision. Cataracts may be caused by a number of different factors, but most are attributable to age. The only way to treat cataracts is with surgical removal of the cataract lens. Cataract surgery has been performed for thousands of years in some crude fashion, but modern cataract surgery has come a long way in just the last decade or so. Dr. Ilan Cohen at the Fifth Avenue Eye Center has extensive experience performing cataract surgery and utilizes the most current techniques and Technology to benefit his patients. Under his skilled hands, the procedure usually takes less than ten minutes.

The lens becomes cloudy and scatters the light. This causes blurred vision

Modern Cataract Surgery Anesthesia:

Cataract surgery consists of several steps. First the eye is numbed, then an incision is made, then the cataract is removed, then an intraocular lens is implanted and finally the incision is closed. In the past, an injection of anesthesia into the eye was used for numbing purposes. Modern cataract surgery, however, uses only topical anesthesia in the form of eye drops. Topical anesthesia has a number of benefits over a needle injection including the absence of pain. Additionally, results from the surgery appear faster and some may be immediate. Patients who only have a topical anesthetic do not have to wear a patch on their eye following surgery, and they do not have to stop taking blood thinner prior to surgery. At the Fifth Avenue Eye Center, this is an outpatient procedure, and patients can usually go home within a couple hours.

A Smaller, Safer Incision:

A topical anesthetic is sufficient to perform cataract surgery in part because the surgery no longer requires a long incision. Surgeons used to have to make an incision in the eye that was at least equal to the size of the crystalline lens and the lens implant. Modern Technology both in surgical equipment and intraocular lenses has made it possible for the entire surgery for cataracts to be performed through a micro-incision on the temporal clear cornea. The benefits of a smaller incision include less trauma to the eye, faster healing time and no need for stitches to close.

One of the reasons such a small incision is possible is because of a Technology called phacoemulsification, or phaco for short. Phaco uses an ultrasonic vibrating needle inserted through the micro-incision to liquefy the cataract lens so that it can be sucked through the incision. The incision doesn’t need to be larger to accommodate the size of the cataract because it is not removed in one piece. Similarly, the incision does not need to be larger to accommodate the size of the lens implant either. Modern lens implants are made of flexible material that can be folded up and injected through the small opening. The implantable lens is then unfolded inside the eye and positioned in place.

Modern Advances in Intraocular Lenses:

Modern intraocular lenses also have added benefits for vision correction. In the past, IOLs were fixed focal lenses calibrated only for distance vision. Today, there are several different intraocular lenses designed to offer clear vision over a full spectrum of distances. Three of the most popular of these implantable lenses are ReStor, ReZoom and Crystalens. These lenses perform similar functions but have different operating mechanisms. The ReStor IOL uses a combination of an apodized diffractive and refractive lens to focus light. ReZoom has multifocal zones that focus light simultaneously. The Crystalens implant is designed to move with the eye muscles to focus vision. Additionally, the AcrySof Toric IOL is designed to treat cataracts and astigmatism. Dr. Ilan Cohen has considerable experience implanting all of these lenses and can help you determine which one will work best for your needs.

Is It Safer?

All of the modern improvements to cataract surgery have individually and cumulatively increased the safety of the procedure. Cataract surgery is less invasive than it has ever been. Consequently, patients can expect fewer complications and better overall results. No surgery is completely risk-free, however. Some complications are possible though rare. The main complication to guard against is infection. Pre- and post-operative antibiotics are generally used to prevent infection from occurring. Other side effects of cataract surgery are usually temporary or easily treated.

Insurance Coverage for Cataract Surgery:

With all of the advances in cataract surgery, insurance coverage has been slow to catch up. Most insurance companies will cover the cost of surgery for cataract removal, but most will not pay for premium specialty lenses like ReZoom or Toric IOLs. Your insurance company may require you to pay for specialty lenses out-of-pocket. At Fifth Avenue Eye Center, we can help you work through the insurance claim processes and answer any questions you might have about this procedure. Schedule a consultation with Dr. Ilan Cohen to learn more about how modern cataract surgery can improve your vision.