Envision Eye Care
Servicing: Saginaw, Cass City, Bay City, Midland

A cataract is a progressive clouding of the eye's natural lens. It is a gradual blurring of vision, usually described as looking through a piece of wax paper. This diminished vision affects quality of life.

Our cataract surgeon, Dr. Krebs can quickly and easily restore both your vision and quality of life by removing your cataract.  Cataract surgery is among the safest of all surgeries, with highly accurate, precise outcomes. This no stitch, no patch eye care procedure is performed under topical anesthesia, and physical activity is minimally restricted post-operatively.

What's new in cataract surgery?

Cataract surgery has undergone tremendous technological advances. New Premium IOL'S (intraocular lenses) have been developed to decrease your dependency on glasses. The Multifocal lens can improve both distance and near vision, and Toric lenses correct for astigmatism.

Read below for more information about cataracts and the lens choices available.

cataractsInside everyone’s eye is a lens. Just like with a camera, the lens of your eye helps you to focus on things whether they are nearby or far away. To work well, the lens must be clear. As you age, the lens of your eye gradually becomes cloudy. We call a cloudy lens a cataract. The word cataract comes from an old Latin word for waterfall. Waterfalls produce heavy mist that can blur your vision. Cataracts have the same effect—blurry vision. Looking through a cloudy lens is like looking through a dirty window—everything is blurred.

Everyone who lives into their 60s develops at least mild cataracts. Early on, the cataract process not only makes your lens cloudy, it also makes your lens swell a little bit. When your lens gets bigger, you become a little more near-sighted. So in the early stages of cataract, simply changing your glasses prescription will usually restore your sight.

But as you continue to get older, the cataract gets more and more cloudy, and eventually not even a change in your glasses prescription will improve your sight. At that point, the only way to restore your vision is to remove the cataract. Cataract surgery is the most common surgical procedure performed on adults in the United States. The procedure is performed on an outpatient basis, generally takes a half-hour or less, and recovery time is usually only a few days.

Cataract surgery is a two-step procedure—first the surgeon removes your cloudy lens, and second, a new lens implant is inserted into your eye. The cloudy lens is removed with a tiny instrument that enters your eye through a small incision—usually one-eighth of an inch or smaller—and gently breaks the cataract into tiny pieces that are then removed from the eye with a miniature vacuum cleaner.

Once the cataract is out, you will need a new lens in order to focus after surgery. Artificial lens implants—made of plastic-like materials—are used to restore your ability to focus after surgery. These implants come in many different strengths, like glasses, and before your cataract operation, your doctor will perform several measurements to determine the appropriate lens implant strength for your eye.

Once your cataract is out and your implant is in, the operation is over. Most people see better within a day or two after cataract surgery, but it is not abnormal or worrisome if your vision seems blurry for a few weeks after surgery as your eye heals. Your doctor will prescribe some eye drops for the healing period after surgery, and if you need new glasses after surgery, these will be prescribed for you once your eye is completely healed, usually about a month after surgery.

Cataracts cannot grow back, but sometimes a thin cloudy membrane grows behind the lens implant, making you vision blurry like the cataract did. This is not uncommon—it happens to roughly 40 percent of patients having cataract surgery. If it happens to you, a quick and simple laser treatment can be performed in the office to make a hole in the membrane for you to see through.


Advances in Cataract Surgery

Modern cataract surgery makes use of an amazing array of high-tech equipment and techniques. Gone are the days when cataract surgery required a two-week stay in the hospital, with your head immobilized with sandbags until you healed. Today’s cataract surgery is an out-patient procedure that takes a half-hour or less and lets you get back to your normal activity level within a few days.

 One of the most dramatic advances in cataract surgery involves anesthesia for the procedure. Long ago, patients were put to sleep for cataract surgery. More recently, patients were given a shot behind the eye before surgery to numb it. But now, the vast majority of cataract surgeries are performed under topical anesthesia, with only a few numbing drops placed on your eye before the start of the procedure. This eliminates both the risks and discomforts of the shot. Also, the shot made the vision blurry for several hours after surgery—with just the numbing drops, some patients notice improved vision within minutes after the surgery is completed.

cataract surgeryThe technique of cataract removal has also undergone major improvements. Once upon a time, the cataract was removed whole through an incision over a half-inch long. Modern cataract surgery is performed through an incision less than an eighth of an inch long. A small instrument is inserted through this tiny incision, and is used to break the cataract into many small pieces that are removed without the need for a large incision. There are many advantages to a smaller incision, including a faster recovery time, less need for glasses after surgery, and a smaller risk of infections after surgery. In addition, while the old incisions required many stitches to close up, modern cataract surgery can often be performed without any stitches, or with one stitch at most.

During cataract surgery, the cloudy lens of your eye is removed and replaced with a clear lens implant. In the old days, there were no implants, and patients had to wear thick glasses (“Coke-bottle glasses”) after surgery to see well. Now there are implants that are placed directly into the eye, reducing or eliminating the need for any glasses after surgery. The newest implants (called multifocal implants, or presbyopia-correcting implants) can even provide sharp vision at both distance and up close, reducing or eliminating the need for any kind of glasses, including reading glasses, after surgery.

Antibiotic advancements also benefit patients undergoing cataract surgery. Cataract surgery is among the most successful operations in all of medicine, but complications can occasionally occur. One of the most severe complications is an infection in the eye called endophthalmitis. To reduce your risk of getting endophthalmitis, your doctor will prescribe antibiotic eye drops to use around the time of your surgery. New antibiotics developed in the past few years are more effective than ever at preventing eye infections during cataract surgery.

Routine cataract surgery is so well tolerated that it has become the most common surgery performed on adults in the United States. As a result of these many high-tech developments in all aspects of cataract surgery, the operation is more successful—and has a faster recovery time—than ever before.

Lens Implant Choices After Cataract Surgery

The lens of your eye is an important structure. In order to see clearly at all distances (from up close to far away), your eye must be able to change its focus power. The lens of your eye is responsible for this change in focus—it changes its shape to bring whatever you’re looking at into clear focus. In your early 40’s you lose the ability to see up close, and require either bifocals, or at least reading glasses. This is because as we age, the lens hardens and cannot change its shape anymore, and in order to focus at different distances, more than one pair of glasses may be required.

As we age even more, the lens becomes cloudy. This cloudiness of the lens is called a cataract. Cataract is a common problem among aging Americans, and cataract surgery is the most common surgery performed on adults in the United States. In cataract surgery, the cloudy lens is removed. In order for you to see clearly afterward, a new lens (called an intraocular lens implant, or IOL) must be inserted at the time of surgery.

lenseSelecting the right implant for your eye is very important for your vision after surgery. Your doctor will take measurements before your surgery to determine how strong your lens is, so an implant with the same strength can be put in during the surgery. If you wear glasses, the implant strength can be adjusted to replace both your lens and your glasses.

Like your aging lens, the implant cannot change its shape to help you see both up close and off at a distance. But several options are available to help you minimize—or even eliminate—your need for any type of glasses after cataract surgery.

For instance, your doctor may place implants in your eyes with the appropriate strength for you to see well at a distance, and you can wear reading glasses when you want to see up close, such as for reading.

Another option is for your doctor to select the implant strength for you to see clearly off at a distance for one eye, and a different strength—the one for up close—for your other eye, so that you can see clearly at all distances without glasses after surgery. This works well for most people, but some people have trouble with depth perception when their two eyes are focused at different distances.

In recent years, several types of bifocal and/or multifocal implants have been developed. These lenses allow you to see clearly at a variety of distances, effectively eliminating the need for glasses. Several manufacturers, including Alcon, Abbott Medical Optics, and Eyeonics, have recently received approval from the FDA for new technology multi-focal lenses following cataract surgery. It should be noted, however, that multi-focal lens technology is evolving rapidly and patients are encouraged to consult with their doctor about these offerings. Also, this technology is relatively expensive and is considered elective by Medicare and most payers.  The difference in price between a standard cataract IOL and the new technology must be paid by the patient.

Talk with Dr. Krebs about the various types of implants available, and their effects on your vision after surgery. The doctor and you will develop a plan that pairs you with the best type of implants for your eyes and your vision needs.

If you have additional questions, please email or call us. We will be happy to help you in any way we can. If you would like to book a brief, free LASIK consultation, click here or call our Laser Vision Correction department at 989-799-2020 in Saginaw, and 989-872-4900 in Cass City .