What is a cataract?
The eye is like a camera. There is a lens at the front of the eye that focuses light. When that lens becomes clouded, it is called a cataract, making it more difficult to see. Cataracts can cause blurry vision, glare, rapid change in glasses prescription, and other symptoms. Cataracts cannot be treated with glasses or medication.
What causes cataracts?
Cataracts develop slowly as we age. About half of the population has a cataract by age 65, and nearly everyone over 75 has a cataract. Other risk factors include family history, diabetes, smoking, some medications, and trauma.
How are cataracts treated?
In the early stages, cataracts are managed conservatively, such as wearing better eyeglasses or using magnifying glasses. When the cataract becomes more advanced, surgery is needed because it is the only curative treatment for cataracts. Cataract surgery is performed with the patient awake but under sedation. Cataract surgery is day surgery and the patient can expect to be onsite at the surgery centre for half a day.
Phacoemulsification (Traditional) Cataract Surgery
The surgeon makes a small incision on the cornea, the surface covering the front of the eye. An opening is carefully made in the capsular bag that holds the lens. A tiny ultrasound probe is used to soften and break up the original clouded lens, which is then removed. An artificial lens (intraocular lens, or IOL) is placed inside the capsular bag. The patient can go home on the same day.
Refractive Femtosecond Laser Assisted Refractive Cataract Surgery (FLARCS)
FLARCS is one of the newest advances in eye surgery techniques. This technique uses a computer-controlled femtosecond laser to make the corneal arcuate incisions, surgical incision, opening in the capsular bag, and softens the cataract. In traditional cataract surgery, a surgical blade and ultrasound energy is used instead.
FLARCS is very safe and yields consistent, predictable results. Due to this high level of precision, the position and orientation of implanted lenses can be controlled for optimal vision. FLARCS is used to optimize astigmatism management by performing relaxing incisions on the cornea or aligning incisions in order to reduce the need for glasses following surgery.
Intraocular Lens Implants (IOL)
No astigmatism correction
These lenses are suitable if you do not have corneal astigmatism and if you do not mind wearing glasses
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Standard lens
The standard lens that comes with cataract surgery is a monofocal spherical lens that can be targeted for near (reading), intermediate (computer), or distance (TV, driving) vision. Most people choose to target the lens for distance vision and wear glasses for near and intermediate work. There may also be a need for distance glasses if you have astigmatism.-
You will need glasses after surgery
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Aspheric lens (high contrast)
Aspheric lenses are monofocal lenses that can minimize spherical aberration
resulting in improved night vision, enhanced colour and contrast, compared to the
standard lens.-
You will need glasses after surgery
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Multifocal lens
These lenses allow for clear simultaneous vision at various zones set according to your eyes. Bifocal and trifocal options are available.
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Reduces need for glasses
Astigmatism correction - Toric lenses
If you have corneal astigmatism, your eye is oval (shaped like a football) and you will need glasses for
all distances after your cataract surgery with the standard lens. Toric lenses can potentially reduce your need for glasses.
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Monofocal Toric lens
Toric lens are custom-ordered to correct your astigmatism. Most people with astigmatism do not
require distance glasses after a toric lens, but this is not guaranteed. Reading and computer glasses will still be required.
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Reduces need for distance glasses if patient has astigmatism
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Multifocal Toric lens
These lenses correct astigmatism and allow for clear simultaneous vision at various zones set according to your eyes. Bifocal toric and trifocal toric options are available.
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Reduces need for glasses at all distances if patient has astigmatism
This is simply an overview of the surgery techniques and lenses available. Not all options may be suitable for you. Book an appointment to discuss with Dr. Cao a personalized cataract care plan for you.
Additional Links
Cataract surgery information by the American Academy of Ophthalmology