New Approaches in Cataract Treatment

In the United States, cataract surgery is one of the most common outpatient procedures and thankfully, one of the most successful. Throughout the years, many patients in our practice have undergone successful cataract surgery that allowed them clearer vision and an improved life experience. These days, much has changed in cataract surgery and a myriad of surgical options abound that create an individualized approach to correcting patients’ vision.

4059660272_ede113355f_zCataract Surgery, a Brief Historical Overview

Historically, cataract surgery simply removed the patient’s cloudy natural lens. While this allowed for more light to pass through the eye to the retina, this left a patient without a lens and thus, a very high glasses prescription. Eventually, patients demanded better outcomes and doctors began to experiment with placing a small, artificial lens in patients’ eyes that created some level of focusing power. Patients were considerably happier though the process was not very exacting and nearly all required some level of vision correction in the form of glasses or contact lenses after the procedure. Again, patients demanded more and doctors developed formulas that calculated the lens power necessary to correct a patient’s distance prescription. As a result, many patients were able to see better than they had in years.

New Approaches

Over the past decade, many surgeons have set themselves apart by creating enhanced visual outcomes for their patients. These surgeons utilize new lenses that offer solutions for patients who have astigmatism (toric lenses) and also offer options for patients who wish to see both far and near simultaneously (multifocal lenses). Of course, these enhanced options come at a premium price. Additionally, they are not for every patient. For example, a patient with eye disease may not be a candidate for a multifocal implant. Patients should inquire as to which options are appropriate to their needs and seek a second opinion if they feel that they need more information or a clearer explanation prior to paying a premium price.
Another option for patients is LASER-assisted cataract surgery. While many of my patients assume that all cataract surgery involves LASERs, in actuality, this is a new method. Historically, cataract surgery involves the utilization of scalpels, ultrasound, and suction to remove the lens. LASER-assisted cataract surgery uses the LASER to create the incisions, open the lens casing, and break up the lens into pieces. This procedure has been found to be more accurate that the traditional method, but studies so far do not seem to prove that it is more (or less) safe. So, one must truly consider whether the added cost makes a difference.

The Future

While admittedly far on the horizon, cataract surgery may go the way of the dinosaur. Current research is focusing on drops that dissolve cataracts. Since I am asked nearly every day if this is an option, it is my hope to one day say “yes.” That being said, current research is being performed on animals and even if it proves successful in animal-based studies, years of research on patients will follow before it hits the market.

Cataracts are a common and fixable problem. If you have been diagnosed with cataracts, fear not, for many options are available to improve your visual outcome. Just remember, when you speak to your surgeon, make sure to go through all of the options available and choose the one that best suits your needs.

All the best in 2016!

~David Ardaya, OD
California Optometric Association
www.eyehelp.org
www.coavision.org

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