Koby Karp Doctors Eye Institute specializes in Cataract surgery. Whether you are experiencing cataract symptoms or getting information for a relative or a friend, we have provided a great deal of information here to answer some of your questions.
Laser Assisted Cataract Surgery
How laser makes it even better?
Over the last few years there has been an innovation in the use of lasers during cataract surgery. To understand how this changes surgery you must first understand non-laser cataract surgery.
The first step is to make a few small incisions with a blade so that the surgeons can work inside the eye on the cataract.
Next the surgeon must make a circular hole in the natural “bag” that holds the lens, while leaving the “bag” there for later use. Currently a skilled surgeon can use an instrument to make this small circular opening so that the lens can be manipulated during surgery.
Lastly the lens with cataracts must be broken up with an ultrasound machine and removed.
Laser Assisted Surgery
On the first step, the laser can actually make the incisions needed to perform the surgery with precision that can not be obtained with a blade.
The second step is where the laser starts to make the biggest change. Even the most skilled surgeons in the world have a hard time making a perfectly circular opening in the “bag”, whereas a computer assisted laser can make a perfect circle every time. This precision makes the implant stay more centered as the healing process progresses.
Where we think the largest benefit come from is the breaking up of the cataract. The laser can cut the lens into small pieces before any instrument is even inserted into the eye. This causes the surgeon to use less ultrasound energy INSIDE the eye while removing the cataract. Studies are being done now to show how using less energy in the eye may cause less post-surgery complications.
Because our doctors at Koby Karp Doctors Eye Institute like to keep up with the latest technology we are currently researching the leading laser systems so that we can provide the best possible care to our patients.
To learn more about Laser Assisted Cataract Surgery watch this video about the Catalys system:
If you are interested in learning more about laser assisted cataract surgery, make an appointment to see one of our surgeons for a consultation at 502.897.1604.
Intraocular Lens (IOL)
An Intraocular Lens implant is a lens inserted into the eye where it remains permanently. It is never necessary for the patient to touch or remove it. Intraocular Lens is about the same size as a contact lens and does not result in distortion as do thick glasses. This procedure does not change the outward appearance of the eyes. Even if a lens has been implanted in your eye, it may be necessary to wear regular glasses after surgery. The strength of the implant is determined for you based on computerized measurements and tests before the operation.
Here's great news for cataract patients! Over the last decade, multi-focal intraocular lenses and toric (astigmatism) lenses, often called "premium" intraocular lenses, have allowed cataract surgery patients to enjoy a greater level of spectacle freedom. These new technologies have helped reduce the need for glasses for those patients who have astigmatism , strong eyeglass corrections and even for different ranges of distance, such as for reading and driving.
Premium Intraocular Lenses
Drs. David Karp, Scott Hoffman, and Connie Meredith are now making the "premium" multi-focal intraocular lenses available to our patients having cataract surgery. Each person and each eye are different so our doctors will discuss with you the options of vision correction with cataract surgery and recommend the best plan to meet your individual visual needs.
The AcrySof® ReSTOR® IOL was designed to provide quality near to distance vision by combining the strengths of apodized diffractive and refractive technologies. Similar technology has been used for years in microscopes and telescopes to improve image quality and has now been patented for use in intraocular lenses by Alcon.
To get more valuable information about the ReSTOR® IOL go to: https://www.acrysofrestor.com
To see what benefits a multifocal lens may provide, click on the implant simulator below to see what each lens can do for your vision. This will help you understand your options when discussing what is best for your eyes with your surgeon.
Patient Testimonials for Multi-focal IOL
Listen to what our patient Joe says about premium intraocular lenses.
"Some friends of mine who have had cataract surgery and just got the regular lenses are envious of me because I can see without glasses, even up close! My decision to get the premium lenses was one of the best decisions I ever made!" Ms. N.D. - St. Matthews
"My husband says I was really smart to get the premium lenses when I had cataract surgery. He says now that he is really sorry that he didn't get the premium lenses when he had his surgery. I feel badly for him but I am very glad for me." Mrs. T.L. - Crestwood
"After all these years of wearing glasses, I still can't believe I don't need them anymore...but I don't." Mr. RKF, Jr. - Jeffersontown
"I almost decided to have the standard lenses put in when I had it (cataract surgery) but the doctor told me about the benefits of having the premium lenses so I would be able to see without needing glasses. And I agreed to do it. And he was right. I don't even need them to watch TV!" G.F. - Louisville
Further good news is that the Centers for Medicare and Medicaid Services do now allow Medicare beneficiaries to choose these more expensive lenses as long as they pay for the extra cost themselves. Doctors and Medicare patients will have the freedom to select technology to treat cataracts that is consistent with the patient's lifestyle. Previously, the government paid most of the price of treatment, including surgery, insertion of a traditional intraocular lens, and one pair of eye glasses or contact lenses. In the past, Doctors were not allowed to exceed Medicare's established price for the procedure or to ask patients to make up the difference for the multifocal or toric lenses. Medicare patients couldn't pay extra for a "premium" lens. Now the rules have changed.
What is a cataract?
A cataract is a clouding of the normally clear lens of the eye. Cataracts can develop in one or both eyes. They can be the result of aging, trauma or certain diseases. A cataract could be compared to a window that is frosted or yellowed. The lens which becomes cloudy is behind the iris and pupil, so it is not generally visible on the outside of the eye.
What are the most common causes of cataracts?
Causes can include medical problems such as diabetes, medications (especially steroids) or injury to the eye. The most common type of cataract is related to slow aging of the eye with gradual thickening and yellowing of the lens. These changes are, in many respects, normal over time, but when the quality of vision is compromised, we call this cataract. Sunlight, chronic illness, oxidation stress, metabolic diseases and genetic features may al play some role in development of cataracts.
What are some symptoms of cataracts?
Some common symptoms of cataracts include a blurring of vision, glare around stars and lights, double vision in one eye or poor night vision. You may need brighter light to read and notice colors becoming less vibrant, fading or yellowing. Early on, people notice more problems at night such as driving on rainy nights, halos and glare. Later, visual acuity becomes worse, with blurring of small print and distant objects such as road signs and TV print.
How is a cataract detected?
A thorough eye examination can detect the presence of a cataract. This examination can also detect any other conditions that may be causing you to have blurred vision or other eye problems.
Some patients may have problems with other parts of the eye, such as the retina, cornea, or optic nerve which can be responsible for vision loss. These problems could prevent improvement in vision after cataract surgery. Therefore, cataract removal may not be recommended if improvement in your vision is unlikely. Your doctor can tell you how much vision improvement is likely.
How long does it take for a cataract to develop?
The rate of development can vary among individuals and may also be different between the two eyes. Most age-related cataracts can progress gradually over a period of years. It is not possible to predict exactly how fast cataracts will develop in any given person. Some cataracts, especially in younger people and people with diabetes, may progress rapidly over a short time.
How are cataracts treated?
A cataract can only be removed with surgery. The right time to remove the cataract depends on your daily visual needs. Surgery may not yet be needed in cases where the symptoms of the cataract are not causing discomfort or inconvenience. In some cases, a change in your eyeglass prescription may be helpful.
By using a small incision (2-3 millimeters), no-stitch ultrasonic technique of lens removal and intraocular lens implantation, clear vision can be efficiently restored. For those patients who develop "secondary" clouding of the lens months or years after cataract surgery, we have a laser in the office for convenient treatment of this condition
There are no medications, exercises or dietary supplements that have been proven to either cure or prevent cataracts.
Protection from excessive sunlight is recommended to help slow the progression of cataracts. Wearing sunglasses that screen out ultraviolet (UV) light rays or regular glasses with a clear, anti-UV coating can provide such protection.
When should cataract surgery be done?
It is time to consider surgery for cataracts when your visual impairment interferes with your job or daily life. It is not true that cataracts need to be "ripe" before they can be removed. Likewise, cataracts do not need to be removed just because they are present.
Cataract surgery should be performed when your daily visual needs require it. Your decision should be based on whether or not you can see to do your job, drive safely and engage in such activities as reading and watching TV in comfort. Can you see well enough to perform daily tasks such as cooking, shopping or taking medications without difficulty?
You and your doctor should decide together when surgery is appropriate based on your symptoms.
What can I expect from cataract surgery?
Cataract surgery is most often performed on an outpatient basis using local or topical anesthesia. During the procedure, the cloudy lens is removed from the eye. One method of cataract removal uses high frequency sound waves to gently break the cataract into tiny pieces. These pieces are then removed by delicate suction. Then the focusing power of the natural lens is restored by replacing it with a permanent intraocular lens implant.
Correction for Astigmatism
Astigmatism is an irregularity in the shape of the cornea. There are degrees of astigmatism that may cause blurred vision even after the cataract surgery has been performed. Low to moderate astigmatism may be corrected by Limbal Relaxing Incisions (LRI) or a Toric IOL. For more information about the LRI procedure, click here.
For patients with higher amounts of astigmatism, your surgeon might recommend a Toric implant. Correcting the astigmatism by implanting the lens inside the eye gives you better clarity of vision than a non-astigmatism implant with glasses. These implants are designed to correct higher amounts of astigmatism than the LRI procedure discussed above.
Even though cataracts are a common cause of decreased vision, particularly for the elderly, they are treatable. Your ophthalmologist can tell you whether cataract is the cause of your vision loss and can help you decide if cataract surgery is appropriate for you. It is important to have a comprehensive eye exam with your eye doctor to see if there are any other problems which could be causing your vision problems.