Cataracts and Cataract Surgery

 A cataract is the thickening of the eye’s lens. Overtime, this “clouding” begins to restrict the light flow to the retina, causing eyesight to become blurred and dim, with the visual acuity similar to someone looking through a foggy window. Eventually, if no action is taken, total vision loss may occur. Though this condition is chronic and arguably inevitable, cataract surgery is a safe and effective solution, with a 98% success rate of improved vision in patients. 

The eye's natural lens is that part of the eye that allows it to focus on objects at varying distances.  The primary function of the lens is to bend and focus light to create a sharp image. 

The term "cataract" refers to clouding of the eye's natural lens. Visually significant cataracts are often described as appearing similar to looking through a foggy or dusty car windshield. Things may look blurry, hazy or less colorful with a cataract.  

Although cataracts typically develop slowly over time. When they become significant enough to impede daily activities, they can only be corrected with surgery.  If your cataract symptoms are not bothering you very much, you do not have to remove the cataract. You may simply need a new eyeglass prescription. You should consider surgery when cataracts keep you from doing things you want or need to do.  If a new glasses prescription does not improve your vision, it is likely time for cataract extraction and implantation of a new (synthetic) lens.

Choosing the right lens depends on your eye health, lifestyle, and visual goals. Some patients are comfortable wearing glasses after surgery, while others may want to reduce their dependence on glasses for distance, near vision, or both. Dr. McConnell will review your measurements and discuss which lens options may be appropriate for you.

• Clouded, blurred, or dim vision
• Shadows and color vision become less vivid
• Glare, sensitive to light
• Seeing "halos" around lights
• Frequent changes in eyeglass or contact lens prescription
• Fading or yellowing of colors
• Double vision in a single eye

Cataract surgery may be appropriate when cataracts begin to interfere with your daily activities or quality of vision. Common reasons to consider surgery include difficulty driving—especially at night—trouble reading, increased glare or halos around lights, faded or less vivid colors, and vision that is no longer adequately improved with glasses.

The decision to proceed with surgery is based on more than the appearance of the cataract alone. Dr. McConnell will evaluate your overall eye health, the severity of your cataract, your visual needs, and whether other eye conditions may be affecting your vision.

You may be a good candidate if:

• Your cataract is affecting activities that are important to you. 
• Your vision remains blurry or limited despite an updated glasses prescription. 
• Glare, halos, or poor night vision are making driving more difficult. 
• Your eye is otherwise healthy enough to benefit from cataract surgery. 
• You understand the expected benefits, limitations, and lens options available to you. 

Cataract surgery is highly individualized. Dr. McConnell will help you decide when surgery makes sense and which lens option best fits your eyes and lifestyle.

Cataract surgery is performed by the ophthalmologist (surgeon), guided with a specialized microscope and a phacoemulsification (phaco) machine. The surgeon makes an incision (capsulotomy) into the capsule of the cloudy lens to surgically remove it. Dr. McConnell removed the cataract via extracapsular cataract extraction (ECCE).

ECCE surgery consists of removing the lens, but leaving the majority of the lens capsule intact. High frequency sound waves (phacoemulsification) are sometimes used to break up the lens before extraction. The cataractous lens is removed and replaced with a plastic lens (an intraocular lens implant) which stays in the eye permanently.

Cataract operations are performed using a local anesthetic, and sedative medication given through the I.V. Patients go home the same day. 

Most post-surgery complications are low-risk and easily treatable. If a complication does arise, it is most commonly a posterior capsule opacification (PCO), or the slight thickening of the lens capsule due to a regrowth of the cells. This is not a new cataract because cataracts cannot grow back. However, this thickening can cause slight blurriness and sensitivity to bright lights. The cloudiness can be corrected with a procedure called a YAG Laser capsulotomy, which Dr. McConnell is able to perform in the office. He uses a laser to make a small hole in the back of the lens, allowing light to pass through to the retina. PCO affects only about 20% of cataract surgery patients.