Like gray hair and wrinkles, cataracts are something that most of us will have treated at some point in our life. The good news is, in many ways, people come out from cataract treatment with better vision than they had even before they developed a cataract. The reason? With modern cataract treatment, surgeons are now able to fix cataracts and vision problems like nearsightedness, farsightedness, and astigmatism all at the same time. Many of our cataract surgery patients in San Antonio and South Texas are surprised to hear that cataract surgery often means ridding themselves from dependency on glasses and contact lenses!
What is a cataract?
Cataract development simply means the natural lens of the eye is losing its clarity. Not everyone knows this, but we all have a small natural lens, basically the size and shape of an M&M candy, that sits directly behind the pupil of the eye.
When we are young, the natural lens is perfectly clear, see-through, and flexible, providing a full range of crystal clear vision from near-to-far. The natural lens is made of protein material, similar to that in our hair and nails. With time, it will start to denature. Our hair starts to turn gray, our nails become more brittle, and the lens of our eye starts to go through 3 stages of “lenticular dysfunction.” We all go through this.
The first sign of dysfunctional lens syndrome typically occurs in the middle 40’s. That’s the age when most people start needing either reading glasses or bifocals put into their regular glasses. At this age, the natural lens has stiffened enough that it will no longer zoom in and out. People notice they need to hold things further out to read until finally, their arm is not long enough, and they often resort to getting some reading glasses.
The 2nd stage of dysfunctional lens syndrome tends to occur more into the 50’s or early 60’s when many people start to notice that their night vision is not quite as clear, they need more light to read, and things are starting to get a little tougher to see, especially fine-detail up-close, even with reading glasses. At this stage, not only has the natural lens lost its zoom capability, but it is also starting to lose some of its clarity. Optical aberrations start to develop that scatter light and cause difficulty with what used to be sharp and clear vision.
The 3rd stage of dysfunctional lens syndrome is a full-fledged cataract. You may have seen pictures in magazines of people in various parts of the world with pupils that look white instead of black. These are mature cataracts, where the natural lens has become optically opaque. Most people in the United States choose to undergo treatment before it gets to that extent.
When people start to develop cataracts, they often think there is a problem with their glasses. Sometimes, it’s a feeling like the glasses need to be cleaned. However, no amount of Windex or scrubbing seems to do the trick. Other times, people think they simply need an adjustment in the glasses prescription. In fact, changing the glasses power will often help at the start of cataract development. However, changing the glasses is only a short-term solution, and often cataract surgical treatment turns out to be the definitive cure. Besides a sense of blurry vision and a feeling like glasses need to be cleaned, the following are common symptoms that many of our patients report when cataracts are starting to become noticeable:
- Difficulty with Night Vision
- Trouble seeing the fine print
- Difficulty reading
- Trouble reading sports scores or the news ticker at the bottom of the TV
- Colors seem faded
- Others simply say they just can’t see well
What happens during cataract surgery?
Cataract surgery has been a very successful procedure for many years. In fact, cataract surgery currently stands as the most common surgical procedure performed in the United States. Over time, cataract surgery has gone through several advancements with surgeon experience, medical innovation, and technology. Innovation in cataract surgery has been rapid. It really wasn’t that long ago, as recently as the 1960’s and before, that cataract surgery was a much bigger ordeal for people than what it is today. In those days, people often had to be admitted into the hospital for a cataract procedure. At that time, all steps were done manually (by hand), and patients were often put on strict bed-rest, sometimes for up to 2 weeks! Successful cataract surgery in those days meant removing the cataract. However, there was nothing to replace it with. Simply removing the cloudy cataract helped with overall clarity, however, patients were then required to wear big, heavy, coke-bottle glasses to see anything!
Thankfully, this is no longer the case. With modern cataract treatment, we always replace the cataract with an intraocular lens implant (IOL), which helps to rehabilitate the vision. Most patients are able to go home the same day, and often feel well enough to do most normal activities by one day later. Depending on the type of cataract surgery performed, many patients nowadays will come out from cataract surgery with less dependency on glasses and contact lenses than they had even before the cataract developed in the first place.
Dr. Parkhurst discusses the LENSAR Cataract Laser
What is the Recovery Like for Cataract Surgery?
Cataract surgery recovery is relatively quick for most people. For example, many people are feeling well enough to work and even drive a car within a couple of days. Temporary eye drops are often prescribed during the healing period, and it is important to maintain postop check-ups according to instructions by the doctor. It is typical to have a check-up on 1-day, 1-week, and 1-month to ensure proper healing of the eye.
Understanding the difference between basic manual and advanced laser cataract surgery
Basic manual cataract surgery is an effective way to rid the eye of a cloudy cataract causing vision problems. It is done manually by hand. A lens implant is used to rehabilitate the eye, often resulting in some improvement in distance vision. Basic cataract surgery does not involve the precision of a laser to perform critical steps of the procedure like making adjustments in astigmatism for best visual quality. The expectation with basic cataract surgery is improved overall clarity, and persistent dependency on glasses and/or contact lenses.
Advanced Laser Cataract Surgery
The vast majority of our patients opt for advanced laser cataract surgery. With advanced laser cataract surgery, a femtosecond laser is used to soften the cataract for a gentler, easier procedure on the eye. The laser is used to make adjustments in astigmatism for best visual quality. That, in combination with a particular advanced technology IOL, will result in less or in many cases no dependency on glasses after the procedure, even if glasses have been needed all your life up until that point. Your doctor will recommend whether it is advisable to focus primarily on treating distance vision, near vision, or both, depending on your eye health, work, hobbies, and personal preferences.
Costs of cataract surgery
When cataracts are causing people functional limitations due to poor eyesight, it is often time to undergo cataract surgery. Most health insurance companies will cover basic cataract surgery. A person’s only financial responsibility for this basic procedure is typically deductibles and co-pays according to each individual health insurance plan.
When advanced laser cataract surgery is performed, health insurance is still billed and covers the basic cataract treatment. Additional fees are charged on top of what the insurance does for laser astigmatism treatment and advanced lens implants that give you more. Vision plans for glasses and contact lenses typically do not apply to cataract surgery. Financing is available for those who qualify.