Cataract surgery

A cataract is a clouding of the lens in your eye, which can cause blurry vision and glare.

Cataract surgery

Types of Dry Eye

The RxSight® Light Adjustable Lens™ (LAL) is the first and only FDA-approved intraocular lens that can be customized to your specific visual needs after cataract surgery. 

Customized results

The Light Adjustable Lens (LAL) offers unparalleled flexibility by allowing post-surgical adjustments to fine-tune vision to the patient’s needs. This revolutionary lens can be modified with UV light after implantation, ensuring patients achieve optimal visual clarity that can be customized even after surgery. Dr. Manusis can preview and adjust your vision to your own personal visual requirements after the lens has been implanted.

Light Adjustable Lens

Cataract surgery involves the removal of the cloudy natural lens and replacement with an artificial lens implant. It is one of the most common and successful procedures performed worldwide, helping millions of people restore clear vision. Thanks to continuous advancements in technology and techniques, the field of cataract surgery has evolved significantly in recent years. These innovations in cataract surgery not only enhance the precision and safety of the procedure but also improve visual outcomes and the overall patient experience. Cataracts, once removed, do not recur.

    Who is Cataract Surgery for?

    Everyone gets cataracts as we age. Cataract surgery is recommended for individuals experiencing blurry vision, glare, or difficulty with tasks like reading or driving due to cataracts. It’s ideal for patients who want to regain independence and quality of life by eliminating visual limitations.

    What to Expect

    The process begins with a thorough eye examination to assess the extent of cataract development. Dr. Manusis then assists with the intraocular lens selection process to improve vision and reduce dependence on glasses. Intraocular lens selection depends on the overall health of the eye as well as the patient's daily visual needs. Making the right decision is crucial as the implants are there for life. The surgery is then performed in the ambulatory surgery setting. It usually takes about 15-30 minutes with light sedation. Patients can expect a smooth recovery with minimal downtime or discomfort.

    When Is Cataract Surgery Necessary?

    Cataract surgery is recommended when vision impairment starts to interfere with everyday tasks such as driving, reading, or recognizing faces. If vision difficulties affect your quality of life, it’s time to consult an eye specialist about surgical options.

    Types of Intraocular Lenses (IOLs)

    • Standard IOL: The monofocal lens is designed to correct vision at one zone only: near, intermediate, or far. You may still need eyeglasses or bifocals after surgery to see all three.
    • Multifocal IOLs: These are similar to progressive glasses, with different focusing strengths built in. This allows your eye to focus on things near, far, and in the middle, with less need for eyeglasses or contact lenses.
    • Extended Depth of Field IOLs: This type of lens enables clear distance and intermediate vision. However, you might still need reading glasses for small print, and some people see streaks of light at night.
    • Toric IOLs: Astigmatism-correcting lenses, called toric lenses, can permanently correct astigmatism. Multifocal toric lenses are also available, which correct for near, far distances and astigmatism.
    • Light Adjustable Lens (LAL) from RxSight: LAL lenses offer the highest level of customization. They are made from a photosensitive material that changes the power of the implanted lens in response to ultraviolet light. We can fine-tune the lens power even after the initial surgery, giving a level of accuracy that other lenses don't offer.
    • Pinhole Intraocular Lens, IC-8 Apthera: This lens corrects near, intermediate, and far vision. We implant this lens in just one eye, to aid distance and near vision. In the other eye, we place a monofocal or monofocal toric lens to correct for astigmatism and improve your intermediate vision. The brain processes the different visual signals from each eye into a single picture. This approach is especially beneficial for patients who are not candidates for a Multifocal lens implant.

    Benefits of Cataract Surgery

    • Restored Vision: Clearer sight enhances the ability to read, drive, and recognize faces.
    • Greater Independence: Reduces reliance on corrective lenses.
    • Improved Quality of Life: Better vision supports mental well-being and engagement in daily activities. Read more in the article: Cataract removal linked to a reduction in dementia risk.
    • Safety: Reduces risks of falls and accidents associated with impaired vision.

    Laser Cataract Surgery vs. Traditional Surgery

    Laser-assisted cataract surgery uses advanced laser technology to create precise incisions and soften the cloudy lens for easier removal. This technique enhances accuracy and customization, leading to improved outcomes and faster recovery.

    Post-Surgery Recovery

    After cataract surgery, mild discomfort, light sensitivity, or itching is normal. Most patients notice significant vision improvement within a day, with continued progress over the following weeks. Key recovery tips include:

    • Using prescribed eye drops to prevent infection and inflammation.
    • Avoiding strenuous activities and swimming for about a week.
    • Attending follow-up visits for post-surgery monitoring.

    Insurance and Cost Considerations

    Cataract surgery is generally covered by insurance, including Medicare, as a medically necessary procedure. Standard IOLs are typically included, but premium lens options may require out-of-pocket costs. It’s advisable to check with your insurance provider for specific coverage details.

    Will I Still Need Glasses After Cataract Surgery?

    Whether you need glasses after cataract surgery depends on the type of intraocular lens (IOL) used.  Standard monofocal IOLs correct vision at a single distance, so glasses may still be needed for near or far vision.

    Premium IOLs can address refractive errors such as nearsightedness, farsightedness, astigmatism, and presbyopia, reducing the need for glasses.

    Your doctor can help determine the best IOL option based on your vision needs.

    Choosing the Right Surgeon for Cataract Surgery

    Selecting a skilled and experienced surgeon is crucial for optimal cataract surgery outcomes. Factors to consider include:

    • Expertise: Proven experience in advanced cataract procedures.
    • Personalized Care: A tailored approach to meet individual visual needs.
    • State-of-the-Art Technology: Utilization of advanced surgical tools for precision and effectiveness.
    • Comprehensive Follow-Up: Ongoing post-operative care to ensure successful recovery.

    Corneal cross-linking is a surgical procedure aimed at:

    • Patients with progressive keratoconus, where the cornea becomes thin and weak.

    What does the procedure involve?

    Riboflavin (Vitamin B2) is applied to the eye every 5 minutes for 30 minutes, and then the cornea is illuminated with UV-A light for approx. 10 – 30 minutes. The eye is covered with a bandage contact lens which is removed 5 to 7 days after the procedure. The cornea will be examined and scanned at frequent intervals to monitor for its stability.

    Common Symptoms

    Signs you may have dry eye syndrome include:

    • Blurred vision
    • Burning or stinging
    • Feeling like something is in your eye Itching
    • Itching
    • Pain when you wear contact lenses
    • Sensitivity to light

    Causes Dry Eyes?

    Allergies
    Seasonal or environmental allergies (like pet dander) cause eye dryness and redness.

    Medications
    Medicines like antidepressants, antihistamines, decongestants and oral contraceptives can reduce your tear production.

    Blepharitis
    Blepharitis is an inflammatory condition of eyelid margins associated with meibomian gland dysfunction and poor lipid production resulting in premature tear film evaporation and dry eye.

    Diabetes
    People with diabetes have decreased corneal sensation and therefore do not produce enough tears to provide an adequate tear film. 

    Autoimmune diseases

    • Sjögren’s Syndrome
      This is a relatively common autoimmune condition involving arthritis, dry skin, dry mouth, and dry eyes. Females are more likely to present with this condition, which can be detected by a blood test.
    • Rheumatoid Arthritis
      This common arthritic autoimmune condition can predispose to severe dry eyes. It can be diagnosed with blood tests and a detailed history.

    Refractive surgery
    It is now established that post-LASIK patients will experience dry eyes in the short term.  Once corneal nerves repopulate, dry eye symptoms typically improve. 

    Contact Lenses
    Long-term use of contact lenses decreases sensation, especially when worn overnight. Various treatment options are available to ensure comfortable long-term contact lens tolerance.

    Eye fatigue
    Long-term computer use and reading both have one thing in common — a reduced rate of blinking. After a while, the eyes feel fatigued, and vision blurs due to increasing dryness.

    Environment
    Airplanes, sitting near air-conditioners, prolonged use of computers, or forced air heating, driving a car, and lack of sleep all can cause dry eye symptoms.

    Dry eyes also have dietary components. Increasing water intake and decreasing caffeine and alcohol consumption will most likely improve tear film.

    Eyelid disorders
    Poor eyelid closure, sleeping with eyes partially open, or having a poor blinking reflex can lead to eye exposure and dryness.

    Risk Factors

    Age
    People older than 50 are at a higher risk for dry eye. Tear production and meibum (oil) production decline with age.

    Sex
    Women are more likely than men to have dry eye due to fluctuating hormones, especially during pregnancy and menopause.

    Smoking
    Smoking and exposure to second-hand smoke increase your risk of eye irritation and dryness.

    Vitamin A and Omega-3 Deficiency
    Low levels of vitamin A or Omega-3 fatty acids can contribute to dry eye syndrome.

    Treatment Of Dry Eye

    Autologous Serum Eye Drops
    Serum eye drops come from the patient’s own blood serum. They resemble natural tears and contain critical biological factors that can help treat dry eye disease.

    Eyelid Thermal Treatment (TearCare®):
    TearCare is an eyelid thermal treatment that combines localized heat therapy with manual compression of the eyelids. It treats meibomian gland dysfunction and improves oil production.

    Medicated Eye Drops
    Your provider may prescribe eye drops that help your eyes increase tear production.

    Ointment
    Medicated ointment helps to reduce inflammation on the surface of your eyes.

    Special contact lenses
    Special contact lenses can help treat ocular surface diseases, including dry eye disease.

    Tear Duct Blocking
    Small silicone plugs are placed in your tear ducts to slow the drainage of your tears. This helps your eyes retain more moisture and helps the tear film better lubricate your eyes.

    BlephEx
    A special medicated brush cleans eyelids to remove debris and bacterial toxins.

    More info can be found at: Dry Eye Statistics

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