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Palisades Office:
910 Via de la Paz
Pacific Palisades, CA
(310) 454-5521

 

Studio City Office:
12229 Ventura Blvd.
Studio City, CA
(818) 623-8900
 

What is a cataract?

A cataract is a clouding of the eye's natural lens. Depending on the degree of cloudiness, a cataract can cause a little blurring or severe loss of vision. The rate at which a cataract progresses is highly variable. It is not a tumor or a growth. It is not a film over the eye that can be peeled away. Vision can only be restored by surgical removal of the cataract. One out of every fifty people will find it necessary to have this cloudy lens removed. Approximately 1,000,000 cataract operations are done each year in the United States.

The majority of cataracts form later in life as a normal part of the aging process. Some people develop cataracts earlier than others without any other eye problems. Cataracts can develop as a result of injury, eye disease, systemic problems (such as diabetes), side effects from certain medications, and in some rare cases babies are born with them. Cataracts are not caused or worsened by reading, watching too much television, sewing, or any other normal visual activity. Limiting your visual activity will not slow down the progression of a cataract.

Cataract treatment

A cataract occurs from the denaturing of protein of the natural lens. Currently, the only effective treatment for cataracts is surgical removal. Medications cannot stop cataract formation. The modern form of cataract surgery, called phacoemulsification, utilizes a small (2mm) incision to permit a probe to enter the cataract and dissolve it using ultrasound energy. The incision may or may not require any sutures to close it. This method allows rapid healing and recovery of vision. 

Once the cataract is removed, a synthetic lens is required to focus the eye. This is usually accomplished with an intraocular lens:

Intraocular Lens (IOL) :  A lens implant (intraocular lens or IOL) is a man-made, clear plastic lens approximately 6 mm in diameter which is placed inside the eye at the time the cataract is removed. It replaces the natural lens and remains permanently within the eye. The lens has small spring-like arms called haptics that prevent the lens from moving out of place.The IOL is placed in the eye during surgery and replaces the cloudy natural lens. In the past twenty years, millions of implants have been used in the United States. The presence of the IOL maintains the normal configuration of the eye and rarely needs to be replaced. 

Surgery and laser treatment

An ophthalmologist will decide on the most appropriate type of operation for the eye. All eyes are different, and generalizations should not be made. The type of cataract extraction and whether or not a lens implant is inserted will vary. In phacoemulsification or extracapsular cataract surgery, a protective clear capsule is retained in the eye. In up to 50% of patients, this clear capsule, through a normal process of cell regeneration, may become cloudy causing the vision to become hazy. This is not another cataract. In these patients, a laser procedure may be required months to years later. This opening of the cloudy membrane is called a capsulotomy. In the past this was done surgically, but at present is done using painless laser techniques.

In an eye with a normal retina (the back portion of the eye), excellent vision is usually achieved. Individuals with other eye problems such as glaucoma, previous retinal detachments, previous eye surgery or injury need special care, but significant visual improvement is often possible.

Preparation for cataract surgery

Once the patient and physician have decided to remove a cataract, a surgery date will be scheduled. An ultrasound instrument is used to determine the optimal power of the intraocular lens to be implanted during surgery. Normal glasses are still worn for accurate fine focusing at far and near distances.

Day surgery

In the "old days," cataract surgery involved prolonged hospitalization and immobilization. Many people remember their grandparents undergoing this type of operation and are unnecessarily alarmed about surgery. With today's advanced techniques, most patients will be able to do most of the recovery in the comfort of their own home.

The day after surgery, the physician will examine the eye and proper medications and instructions will be given. The date for follow up office visits may also be arranged.

Recovery

Depending on the type of surgery and the specific situation, complete postoperative recovery ranges requires approximately 1 month. At the end of this time, a final refraction for glasses will be done. The eye may continue to heal even past this time, making small refinements in glasses occasionally necessary.

Normal daily activities may be resumed within a day or so following surgery. Heavy or strenuous physical activity should be avoided for the first several weeks; this includes extreme bending or lifting of more than 20 pounds. 

For the first few days after surgery, patients should avoid touching or rubbing the eye. Sunglasses are helpful for bright days. A white patch is worn only for the first 24 hours after the operation.

Eye drops will be prescribed post-operatively. These medications are intended to lessen inflammation, prevent infection, aid comfort, and promote normal healing. 

Complications

As in any surgical procedure, a small element of risk exists, and complications, (e.g., blockage of blood vessels, retinal detachment, corneal decompensation, macular swelling, bleeding, and infection) can occur during surgery or in the healing phase after surgery in spite of the best care. It is impossible to predict in which patients these complications will occur.

No operation of any sort can ever be performed without risk. A very rare complication is the possibility that the intraocular lens will require removal or repositioning. After cataract surgery, over 99% of patients will see significantly better.

For more information, see our frequently asked questions (FAQ).