Cataracts: Diagnosis, Treatments & Designer IOLs

What Are Cataracts & Why Do They Develop?

Your eye works a lot like a camera. Light rays focus through your lens onto the retina, a layer of light-sensitive cells at the back of the eye. Similar to photographic film, the retina allows the image to be “seen” by the brain.

Over time, the lens of our eye can become cloudy, preventing light rays from passing clearly through the lens. The loss of transparency may be so mild that vision is barely affected, or it can be so severe that no shapes or movements are seen—only light and dark. When the lens becomes cloudy enough to obstruct vision to any significant degree, it is called a cataract. Eyeglasses or contact lenses can usually correct slight refractive errors caused by early cataracts, but they cannot sharpen your vision if a severe cataract is present.

The most common cause of cataract is aging. Other causes include trauma, medications such as steroids, systemic diseases such as diabetes, and prolonged exposure to ultraviolet light. Occasionally, babies are born with a cataract.

Cataracts typically develop slowly and progressively, causing a gradual and painless decrease in vision. Other changes you might experience include blurry vision; glare, particularly at night; frequent changes in your eyeglass prescription; a decrease in color intensity; a yellowing of images; and in rare cases, double vision.

As the eye’s natural lens gets harder, farsighted (presbyopic) people, who have difficulty focusing up close, can experience improved near vision and become less dependent on reading glasses. However, nearsighted (myopic) people become more nearsighted, causing a worsening in their distance vision. Some kinds of cataracts affect distance vision more than reading vision. Others affect reading vision more than distance vision.

Reducing your exposure to ultraviolet light by wearing a wide-brimmed hat and sunglasses may reduce your risk for developing a cataract, but once one has developed, there is no cure except to have the cataract surgically removed.

With a routine, outpatient surgical procedure, your ophthalmologist can remove the cataract, making either a small incision (phacoemulsification) or a larger incision (extracapsular extraction). Usually, a synthetic intraocular lens (IOL) is inserted at the time of cataract extraction to replace the focusing power of the natural lens. IOLs can be monovision (fixed-focus for a preset distance) or multifocal, which allows focused vision at many distances. The time to have cataract surgery is when the cataract is affecting your vision enough to interfere with your normal lifestyle.

Cataract surgery is a very successful operation. One and a half million people have this procedure every year in the United States, and 95% have a successful result. As with any surgical procedure, complications can occur during or after surgery, and some are severe enough to limit vision. But in most cases, vision, as well as quality of life, improves.

Designer IOLs

An intraocular lens (IOL) is a tiny, lightweight, clear plastic or silicone disc placed in the eye during cataract surgery. An IOL replaces the focusing power of the eye’s natural lens.

Your eye’s natural lens plays an important role in focusing images on the retina. When a cataract develops, the lens loses its clarity. Light rays cannot focus clearly, and the image you see is blurry. Eyeglasses or contact lenses usually can correct slight refractive errors caused by early cataracts, but they cannot sharpen your vision if an advanced cataract is present.

The only treatment for a severe cataract is to remove the eye’s natural lens and replace it with an IOL. Intraocular lenses offer many advantages. Unlike contact lenses, which must be removed, cleaned, and reinserted, the IOL remains in the eye after surgery.

An IOL may be implanted either in front of or behind the iris. Behind the iris is the most frequent placement site. IOLs can be made of hard plastic, soft plastic or soft silicone. Soft, foldable lenses can be inserted through a small incision, which shortens recovery time following surgery.

The rapid evolution of IOL designs, materials, and implant techniques has made them a safe and practical way to restore normal vision after cataract surgery.  At Florida Eye we utilize several Designer IOLs.  Below are just two of them.

TECNIS^® Multifocal Lens

Designed to give patients back their youthful vision, the TECNIS^® Multifocal Lens provides patients with high-quality vision at any distance, and in any light condition — even in low light.

Superior Results

The advanced TECNIS Multifocal is an implantable lens that restores vision after cataract surgery and corrects presbyopia (the need for reading glasses). It’s the lens 94% of patients would choose again.

It delivers results superior to those of a standard multifocal lens and offers an excellent chance to become spectacle independent.

Exceptional Full Range of Vision

Only the advanced TECNIS Multifocal Lens enables you to see clearly at near, intermediate, and far distances without glasses in all light conditions.

Compare the following images. In the first image, which demonstrates vision with the TECNIS Multifocal Lens, you can see the coffee cup close up, the dashboard at intermediate, as well as road signs in the distance — all clearly.

Now, compare the second image. This image demonstrates what you might see with a monofocal lens. Although the intermediate and distance vision is clear, notice how the coffee cup is now blurry.

Nighttime Driving

Immediately after surgery, some patients may notice rings around lights when driving at night. However, as the eye adjusts to the lens, the visual impression of rings may lessen or go away over time.

Am I a Candidate?

If you are diagnosed with cataracts and are experiencing one or more of the following symptoms, you may be a candidate for the TECNIS Multifocal Lens:

• Difficulty reading
• Difficulty seeing close objects
• Difficulty seeing to drive, especially at night
• Changing glasses prescriptions
• Needing bifocals

Ask your doctor if the TECNIS Multifocal Lens is an option that is right for your lifestyle and eye health.

Crystalens^®

Crystalens is an accommodating intraocular lens that, unlike a standard IOL, can treat both a person's cataracts and presbyopia—loss of near and intermediate vision. You probably noticed in your forties that you started to lose some of your up-close vision and had to start wearing reading glasses. Crystalens not only treats your cataracts (a clouding or hardening of your lens), but can also reduce or eliminate your dependence on glasses. It does so by recreating accommodation similar to your eye's natural lens. The unique Crystalens can reduce or eliminate glasses for most activities, including: reading a book, working on the computer, and driving a car.

Crystalens was modeled after the human eye. Like the natural lens, it uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens dynamically adjusts to your visual needs.

Crystalens is designed to allow the optic, or the central circular part of the lens that you see through, to move back and forth as you constantly change focus on images around you. Crystalens flexes as you focus your vision.

Crystalens is:

• The first and only FDA-approved accommodating intraocular lens
• The only FDA-approved intraocular lens that uses the natural focusing ability of the eye
• The only FDA-approved presbyopia correcting IOL for cataract patients that provides a single focal point throughout a continuous range of vision

Few patients with Crystalens have experienced problems with glare, halos and night vision. Crystalens focuses only one image to the back of the eye, unlike a multifocal lens that projects multiple images, requiring your brain to “adjust” to the differences.

The effectiveness of Crystalens was proven in clinical trials:

• Significantly more patients implanted with a Crystalens (88.4%) could see better at all distances than patients implanted with a standard IOL (35.9%).
• Most patients have continued to report excellent vision 7 years after implantation with Crystalens. More than 100,000 Crystalens implants have been implanted worldwide, and that number is growing daily.

Crystalens accommodates like the natural lens. After implantation of Crystalens, most patients will see brighter and clearer from distance, intermediate to near like they did when they were younger.

STAAR Toric IOL™ for Cataract Astigmatism Eye Surgery

STAAR® Surgical Company developed the world 's first toric IOL (intraocular lens) for the reduction of astigmatism. This exclusive IOL can maximize surgical results by treating astigmatism during cataract eye surgery. Approximately 20 percent of patients who need cataract surgery have a clinically significant degree of preexisting astigmatism.

Background of Astigmatism Eye Surgery

For the past decade, ophthalmic surgeons have tried several methods to correct preexisting astigmatism during cataract eye surgery, including making incisions into the cornea to alter the shape of the eye. Now due to the unique design of the STAAR Toric IOL, astigmatism can be reduced or corrected without further surgical intervention. Like other intraocular lenses, the STAAR Toric IOL restores focus to the eye when the natural lens or cataract is removed, but it is also designed to correct preexisting astigmatism using the same technology that has been successfully used in contact lenses.

The STAAR Toric IOL is designed for those cataract patients with 1.5 to 3.5 diopters of regular pre-existing astigmatism. The STAAR toric IOL is manufactured of time-tested silicone (RMX-3UV) and have been implanted worldwide.

Outcome of Cataract Eye Surgery with Pre-existing Astigmatism

A randomized, prospective, controlled clinical study conducted by STAAR Surgical Company has demonstrated that the implantation of the STAAR Toric IOL is associated with clinically significant reduction in astigmatism as compared to implantation of a non-toric IOL during cataract eye surgery for astigmatic patients. Review the images below to view the difference.

If you are an astigmatic cataract patient, the STAAR Toric IOL may be the right intraocular choice for you. The toric IOL has the capability to provide freedom from corrective lenses after cataract surgery.

The STAAR Toric IOL: May be the Single Best Option for Correcting Cataracts and Astigmatism

The surgery to remove cataracts is an outpatient procedure, and involves replacing the clouded natural lens with an artificial one. However, if you also have astigmatism you may still experience blurred or distorted vision, since the lens typically implanted during ordinary cataract surgery cannot correct this secondary condition.

Astigmatic patients who are planning cataract surgery can request the use of a STAAR Toric IOL during their lens replacement - treating the cataract and the astigmatism at the same time. The STAAR Toric IOL is ideal for cataract patients with regular, pre-existing astigmatism. It has been used safely and effectively in a countless number of procedures.