Refractive Cataract Surgery
What is Refractive Surgery?
Refractive surgery is a set of surgical procedures that correct common vision problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. Patients receive refractive surgery in order to reduce or eliminate the need for glasses and contact lenses. The most common type of refractive surgery is LASIK.
What is Cataract Surgery?
A cataract is clouding of the eye lens. Cataract surgery involves removing the eye’s natural lens in order to remove the clouding. Before 2005, cataract patients were perfectly content having their cataract-clouded lens or lenses removed, and then replaced with standard synthetic lenses. This is still how vision is corrected in standard cataract surgery. However, new technology allows ophthalmologists to replace the cloudy lens with an intraocular lens implant, IOL, as well as reduce or eliminate astigmatism by performing laser cataract surgery. Using the Femtosecond laser, Dr. Sondheimer can perform some steps in cataract surgery more accurately than with other techniques.
What is Refractive Cataract Surgery?
Refractive cataract surgery, a relatively new term, describes the merging of traditional cataract surgery with modern refractive eye surgery techniques. The first part of refractive cataract surgery is the same as standard cataract surgery. Additionally, refractive cataract surgery corrects astigmatism and presbyopia. Refractive cataract surgery enables patients suffering to lose the clouded vision and to greatly reduce or eliminate the need for corrective eyewear.
If cataracts are present patients may experience one or more of the following symptoms.
- Cloudy vision
- Double vision in one eye
- Frequently changing eyeglass prescription
- Interfering glare
- Pale color vision
- Poor night vision
- Trouble seeing to drive or reading during the night or day
- Trouble seeing with bright lights
Candidates for cataract surgery
Patients that want to be less dependent on glasses or have vision-altering cataracts are ideal candidates for refractive cataract surgery. If, in addition to having a cataract in one eye, your other eye is either nearsighted, farsighted, or has astigmatism, refractive cataract surgery may be a good choice for you. Surgery can be tailored to patients that enjoy wearing glasses or prefer to avoid having surgery on their second eye. Dr. Sondheimer will help you decide which choice is better for you.
Refractive Cataract Surgery Options
Typically, ophthalmologists perform cataract surgery on one eye at a time. This is because cataracts can develop in each eye at different rates. However, if patients correct only one eye their eyes can stop working as a team. This leads to patients electing for surgery on the second, now worse, eye. The choice to have surgery on one or both eyes depends on the eye health and the patient’s preferences. There are some advantages of choosing cataract surgery for both eyes including rehabilitating both eyes at one time as well as allowing the eyes to match in clarity and function. In addition, patients who choose to have cataract surgery on both eyes can have one eye corrected for distance vision and one eye corrected for near vision. This use of IOLs is called monovision.
Refractive Cataract Technologies
Over the past decade, multifocal IOLs, toric IOLs, and laser cataract surgery advances have given Dr. Sondheimer the ability to also address refractive problems such as astigmatism and presbyopia. The following are some refractive cataract surgery technologies we use in our office.
- Presbyopia-correcting IOLs and Monovision – At a certain age patients begin to lose their ability to focus on objects that are up close. This is called presbyopia and results in the need for reading glasses to see things such as books or computer screens. In order to fix this, patients elect for multifocal IOLs or monovision surgery. About 70% of patients will are able to adjust to monovision.
- Toric IOLs and Laser Cataract Surgery – In order to solve astigmatism, where the cornea is shaped more like an oval than a sphere, vision at certain distances impossible. Toric IOLs or Laser Cataract Surgery improves astigmatism in Refractive Cataract Surgery.
- ORA Intraoperative Aberrometry, Verion Registration, and OPD Registration – In many patients, Dr. Sondheimer uses Intraoperative Aberrometry to measure power and guide best placements of IOLs. He also uses Verion and OPD instruments along with laser cataract surgery treatment to achieve precise astigmatism correction.
Cataract Surgery Consultation
Dr. Sondheimer meticulously examines and advises each patient before cataract surgery in order to help the patient choose the rehabilitation plan that best serves their needs. Dr. Sondheimer is one of the few cataract surgeons who is also an expert in refractive surgery. As a result, he can use his expertise in reducing the need for glasses through refractive laser procedures when treating his laser cataract surgery patients.
Refractive Cataract Surgery
Dr. Sondheimer is at the forefront of refractive cataract surgery with a combined 22,000 surgical procedures performed to treat cataracts and refractive vision issues. Rather than a standard synthetic IOL, Dr. Sondheimer prefers to place a multifocal IOL to correct presbyopia and a toric IOL to correct astigmatism. Cataract surgery often takes as little as 15 minutes. It may take longer if the lens is very hard or if patients choose to correct their astigmatism at the same time.
Recovery from Refractive Cataract Surgery
Traditional and refractive cataract surgeries have the same recovery. At first, you may experience blurry vision or irritation but that should improve rapidly for most patients. An eye shield needs to be worn for a few days following surgery, including during sleep. In addition, Dr. Sondheimer will prescribe eye drops to reduce inflammation, prevent infection, and control eye pressure. Patients have reported clear vision within hours of surgery, however, it may take additional time for others.