All About Cataracts

A new study of same-day cataract surgery on both eyes suggests the bilateral procedure is safe and effective. That’s good news for anyone who has cataracts in both eyes and wants to see better as quickly as possible.

The study evaluated 94 patients who had cataract surgery performed on both eyes the same day and 100 patients who had bilateral cataracts but had surgery performed on each eye on separate days, which is the way cataract surgery is typically performed.

In the same-day surgical group, the cataract surgeon performed cataract extraction with intraocular lens implantation on one eye, then immediately performed the same procedure on the second eye.

After surgery, the mean visual acuity in the eyes of both groups was approximately 20/25, and no significant difference in visual acuity was noted between the two groups. In addition, 96.8 percent of eyes in the same-day surgical group and 97.0 percent of eyes in the separate-day surgical group were within 1.00 diopter (D) of the desired refractive endpoint, and there were no sight-threatening complications during or after surgery in the two groups.

The researchers concluded that same-day bilateral cataract surgery appears to be a safe and effective option for people with cataracts in both eyes, and patients are very satisfied with the procedure.

The study was conducted by the Department of Ophthalmology, Soonchunhyang University College of Medicine in Seoul, Korea. A full report of the study appears in the March 2009 issue of Japanese Journal of Ophthalmology.

AllAboutVision.com (AAV) announced this month the launch of its new Cataract Surgeon Directory.

The directory will allow AAV visitors to find an experienced cataract surgeon in their area and schedule a consultation to learn more about cataracts, cataract surgery and the latest premium IOLs (intraocular lens implants) used to correct vision in modern cataract surgery.

The new cataract surgeon directory lists prominent eye surgeons located in cities and major metropolitan areas throughout the United States and Canada, and includes detailed information about each doctor, directions to their practice, contact information and a link to their websites.

AllAboutVision.com’s cataract surgeon directory is free and no registration is required.

_____________________

AllAboutVision.com was established in January 2000 and provides consumers independent, trustworthy information about eye health, eyecare and vision correction options. All health-related articles appearing at AllAboutVision.com are developed with input from AAV’s Advisory Board of prominent eye doctors. In 2008, more than 7.8 million unique visitors accessed AllAboutVision.com for information about eye care and eyewear, including contact lenses and vision surgery.

Advances in cataract surgery are occurring every year, making the procedure safer and more effective than ever.

A number of the key advances in cataract surgery took place in 2008. Among the new technology and techniques:

New Phacoemulsification Technology

Phacoemulsification (or “phaco”) is a cataract surgery technique in which the cataract is broken up into small pieces with a small, hand-held probe that has a vibrating tip. The small pieces are then removed from the eye with suction. Phaco is currently the most common technique used for cataract surgery in the United States.

Manufacturers of phaco equipment for cataract surgery introduced several advances in 2008, including probes that allow the procedure to be performed with smaller incisions. This reduces the risk of unwanted astigmatism after cataract surgery. Other advances include new microsurgical tools to help break up very dense cataracts more effectively during phaco cataract surgery.

New Lens Implants

New intraocular lenses (IOLs) introduced or in development in 2008 include presbyopia-correcting IOLs, aspheric IOLs and toric IOLs.

Presbyopia-correcting IOLs

These innovative lenses help restore a person’s ability to see well up close as well as far away, thereby reducing the need for reading glasses and computer glasses after cataract surgery.

The Crystalens HD (Bausch & Lomb) presbyopia-correcting lens that was introduced in 2008 works by having the ability to change position slightly within the eye in response to focusing effort. This type of presbyopia-correcting IOL is also called an “accommodating” IOL. Other brands of accommodating IOLs are currently in development.

Another type of presbyopia-correcting intraocular lens is the multifocal IOL. Multifocal IOLs are similar in design to multifocal contact lenses, containing separate lens powers for seeing distant, intermediate and near objects simultaneously. Examples of multifocal IOLs include The AcrySof ReSTOR IOL (Alcon Laboratories) and the ReZoom Multifocal Lens (Advanced Medical Optics).

Accommodating and multifocal IOLs can be implanted in both eyes, or in one eye only for a “monovision” effect. Some surgeons feel a monovision correction provides better distance vision than having presbyopia-correcting IOLs implanted in both eyes.

Aspheric IOLs

Aspheric IOLs are specially designed to more closely mimic the shape of the eye’s natural lens, which changes in curvature from its center to its periphery. This characteristic of possessing a gradually changing curve is called asphericity (meaning “not spherical,” or “not of the same curve”).

Because they are more similar in shape to the eye’s natural lens, aspheric IOLs are designed to provide sharper vision and reduce higher-order aberrations (HOAs) caused by traditional spherical IOLs. HOAs contribute to glare and reduced contrast sensitivity, especially at night and in other low-light conditions.

Many cataract surgeons appear to believe in the benefits of aspheric IOLs, as the use of thes premium IOLs grew rapidly in 2008.

Examples of aspheric IOLs include the Tecnis IOL (Advanced Medical Optics) and the AcrySof IQ IOL (Alcon Laboratories).

Toric IOLs

Toric IOLs are a new type of premium intraocular lenses that correct astigmatism.

In the past, people who had astigmatism and cataracts had to wear eyeglasses or have an additional surgical procedure to correct their astigmatism after cataract surgery. With toric IOLs, many of these people can see clearly after cataract surgery without the need for full-time glasses or additional surgery.

Use of toric IOLs increased significantly in 2008 and continued future growth is expected. Examples of toric IOLs include the AcrySof Toric IOL (Alcon Laboratories) and the STAAR Toric IOL (STAAR Surgical Co.)

More Advances on the Horizon

As the aging of the U.S. population continues, more and more Americans are having cataract surgery. And more advances in cataract surgery technology are occurring every year, including techniques for smaller incisions and faster recovery time.

To stay up-to-date on the latest news about cataracts and cataract surgery, return to AllAboutCataracts.com often. Or browse AllAboutVision.com’s Cataract Surgeon Directory to find a cataract surgeon near you.

In an educational program for cataract surgeons held November 7 in Atlanta, experts described a number of new options for premium cataract surgery. The program was supported by eyecare products manufacturer Bausch & Lomb in association with Ophthalmology Times.

New Cataract Surgery Technologies Promise Safer Outcomes and Better Vision

New technologies for premium cataract surgery discussed during the program included the Stellaris Vision Enhancement System, the Crystalens HD accommodating IOL, and the Akreos aspheric IOL. All these products are produced and marketed by Bausch & Lomb (Rochester, NY).

Stellaris Vision Enhancement System

The Stellaris Vision Enhancement System is a new surgical platform that allows ophthalmologists to perform phacoemulsification cataract surgery with very small incisions (2 mm or smaller). The Stellaris system also has other advanced controls to increase surgical safety and efficiency.

(Phacoemulsification, or “phaco,” is a cataract surgery technique wherein the surgeon uses a small ultrasonic probe to break up the cloudy lens into very small pieces, which are then removed from the eye with suction. Phaco has become the method of choice for most cataract surgeons because it can be performed with much smaller incisions than traditional cataract surgery, speeding recovery time after surgery.)

Crystalens HD Accommodating IOL

The Crystalens HD accommodating IOL is an advanced intraocular lens (IOL) used in cataract surgery. Unlike other IOLs, the Crystalens HD is capable of slight movements within the eye in response to focusing effort. This “accommodation” restores some intermediate and near vision lost to the normal aging change in the eye called presbyopia. The Crystalens HD IOL thereby reduces the need for reading glasses after cataract surgery.

Akreos Aspheric IOL

The Akreos aspheric IOL is a new intraocular lens with advanced optics that recently gained approval by the U.S. Food and Drug Administration (FDA) for use in the United States. The lens is made of a soft, flexible material (the lens is folded for placement inside the eye and unfolds automatically) and protects the eye’s light-sensitive retina from harmful UV rays from sunlight. The aspheric curves of the Akreos IOL more closely mimic the optics of the eye’s natural lens than other IOLs and thereby provides sharper distortion-free vision, according to the manufacturer.

Multiple Techniques and Lenses for Premium Cataract Surgery

The field of cataract surgery is continually changing and many options are now available for “premium” cataract surgery — surgery that is performed with advanced techniques and/or employs the use of advanced intraocular lenses.

If you are considering cataract surgery, be sure to ask your surgeon about the latest premium cataract surgery techniques and products available. Be aware that premium IOLs may increase your cataract surgery cost.