New procedures are being developed all the time with one of the latest having the added bonus that as the patient approaches middle age she won’t be forced to dig for reading glasses to read a recipe or ingredients on a pill bottle. On top of that, younger patients can get the surgery - without ever having cataracts - to eliminate the need for “cheaters” later in life.
By age 80, more than half of all Americans either have cataracts or have had cataract surgery, according to the National Eye Institute.
Thankfully, cataract surgery and related devices have progressed - glasses with lenses that resemble coke bottle bottoms are a thing of the past, replaced with implanted lenses. Surgery is now an outpatient procedure.
A cataract is the clouding of the lens in the eye that affects vision.
In the future, Dr. Austin Chang, ophthalmologist with the Eye Center of Central Texas, expects there will be a lens that will work for everyone. Also, he predicts lens implantation will take place with the patient in the chair during an office visit.
“It might not happen for 15 years though,” he said.
A couple of new advances in cataract surgery at the Eye Center are the 2.2-mm incision and the Crystals.
Since this summer, Chang has performed about 50 cataract surgeries with a 2.2-mm incision, rather than the typical 3-mm incision.
There is a trend toward smaller incisions, which Chang said provides better results.
The technique is safe and results are better, he said.
The smaller wound reduces postoperative induced astigmatism and reduces the risk of infection.
In most cataract surgeries, a small incision is made on the side of the cornea - the clear, dome-shaped surface that covers the front of the eye. The doctor inserts a tiny probe into the eye. This devise emits ultrasound waves that soften and breaks up the lens so it can be removed by suction.
The lens is then replaced with an artificial lens. The patient, usually a senior citizen, will continue to need glasses because the lens is designed to deliver improved vision at just one distance, usually far.
The young eye typically has the ability to focus on objects, both near and far. However, as an individual ages, the eye’s ability to accommodate the changes decreases, thus the need for reading glasses when approaching middle age.
The Crystalens - the first accommodating intraocular lens approved by the FDA - offers the cataract patient the potential to go without glasses.
All lenses used in cataract surgery have hinges, but Crystalens is the only one that has hinges that enable it to move forward and back, making it possible to focus on objects at various distances.
Linda Cooper, a patient of Chang’s, had to wear glasses for reading and distance for years and had recently developed cataracts.
Cooper chose to have the Crystalens implanted and is happy with her choice.
“I couldn’t see at any distance without discomfort and had to wear sunglasses nearly all the time due to pain from bright lights,” she said.
Since the surgery, Cooper said her vision has improved and lights no longer bother her.
Even without cataracts, “There is a trend for younger adults, those in their 50s or 60s, getting the lens implanted before cataracts develop,” Chang said.
As the technology improves and becomes safer, procedures to improve eyesight have become more mainstream, with younger patients taking advantage of the advances, he said.
Still, it is surgery, so there are risks.With all lens replacement surgery, the eye is measured to determine the correction needed and the lenses are made to order.
Most of the lenses will not correct an astigmatism, which would need to be corrected with a laser procedure, he said.
“People ask if someone will come out with a better lens in the future and the answer is yes,” Chang said. “Lenses will get better and better and technology will continue to progress.”
Crystalens won’t work for everybody, he said. Individuals with eye problems resulting from diabetes, glaucoma and macular degeneration may not benefit from the Crystalens.
“We’ll talk to the patient about their lifestyle to determine what lens fits their needs,” he said.
Insurance covers the cataract surgery portion of the cost of getting Crystalens, but not for the lens or special measurements required. The cost is about $2,500 extra per eye.
