Cataract Surgery

Choosing a Denver cataract surgeon can be difficult if you are not properly educated about what is a cataract and how this cataract is removed. Although cataract surgery is one of the most performed surgeries today, it is serious surgery and you will need a surgeon with credible experience and a strong knowledge of lens implantation.

Cataract surgery is the only way to remove a cataract and restore clear vision. The cataract surgeons at Hines Sight will recommend cataract surgery when cataracts begin to limit your activities.

What happens during cataract surgery?

During cataract surgery, the natural lens of your eye is removed and replaced with a clear artificial lens called an intraocular lens implant (IOL). The surgical process is performed under a special microscope and involves making a small incision and manipulating small instruments inside the eye (intraocular) and is termed intraocular micro-surgery. The removal of the lens material is accomplished, using an ultrasonic needle to emulsify the lens material, phacoemulsification. Once the eye has been properly dilated, the eye is then prepared with a cleaning solution. Topical anesthetic drops are then administered to the surface of the eye. Next, under a microscope, an incision 3 millimeters in length is created at the junction of the cornea (the clear dome on the front of the eye) and the sclera (the white part of the eye). Another dose of anesthetic is then administered inside the eye through this incision. The front part of the lens capsule (envelopes the lens as the skin of a grape envelopes a grape) is carefully opened so that the lens material can be removed. The phacoemulsification is then performed, which pulverizes the hardened and yellowed lens proteins known as the nucleus of the cataract. The emulsified material is simultaneously irrigated and aspirated (vacuumed) from the eye.

Cataract Surgery

Once all of the cataract material has been removed a foldable intraocular lens is then inserted through the original incision and positioned into the remaining "bag" of the lens capsule. The lens will remain inside your eye in this location without moving. Intraocular lenses cannot be felt or sensed in any way by the patient.

Cataract surgery is virtually painless and recovery is quick. Your eye may be patched when you leave the facility, but the patch will be removed the next day. You will notice an improvement in your vision; however, you may still need glasses for some tasks. In 60 percent of cataract surgery patients, the capsule that holds the new intraocular lens becomes cloudy. This can happen anywhere from months to years after the procedure. If this occurs, a laser is used to make a small opening in the capsule. This procedure takes just a few minutes in the office and will make your vision clear again.

Following your cataract surgery at our Denver, Colorado center you will need to carefully follow the post-operative instructions of Dr. William Hines. You must use the eye drops as prescribed and be careful not to rub, bump, or put any pressure on your eye. Be sure to discuss driving and get the proper instructions for driving after cataract surgery. It is normal to feel mild irritation or itching after cataract surgery. You can clean your eyelids, very gently, with tissue or cotton balls to remove any discharge. The doctors at Hines-Sight will prescribe eyedrops or other medication to prevent infection, relieve inflammation, control the pressure of the eye and keep it moist.

If glasses are required following surgery to achieve the best possible vision, either for close up work such as reading, or for distance purposes, these will be prescribed four to six weeks after surgery when full recovery is expected. If both eyes are scheduled to have surgery within a few weeks of each other, then glasses, if needed, will be prescribed following the full recovery of the second eye. Patients may elect for multifocal or premium lens implants after surgery that reduce dependence on glasses. In some cases, glasses may not be required at all. Additionally, LASIK may be performed to enhance the quality of vision after cataract surgery.

Cataract Lens Implant Surgery

The Future of Cataract Lens Implants in Denver

Lens Implant OptionsSurgical ProcessPremium Lens ImplantsToric Lens ImplantsFrequently Asked Questions

1. Introduction to Premium Lens Implants

Cataract Surgery

If your doctor has told you that you are in the early stages of developing cataracts or has suggested that refractive lens exchange would be a good vision correction option, you might want to research the new emerging lens implant technology in the field of ophthalmology. If you are nearing the age for cataract surgery and want a reliable vision correction solution premium lens implants might be a good idea. Premium lens implants have been helping people over 40 and cataract aged patients have the active lifestyle they had when they were younger. Imagine playing golf or being able to read the newspaper with a dependency on glasses. Life without glasses could dramatically impact your overall happiness. This is why the doctors at Hines Sight have been trained in the latest intraocular surgery techniques involving lens implantation with multifocal, accommodating, and toric lens implants also referred to as premium lens implants.

2. Emerging Lens Implant Technology

This intraocular lens technology of modern day ophthalmology has recently made some swift advancements that can dramatically improve a patient's ability to see with lens implants after cataract surgery or even after refractive lens exchange before the development of cataracts. Some of these new intraocular lens implants might even be a better vision correction option than LASIK eye surgery depending on your prescription and age. In the past with LASIK eye surgery our doctors could correct myopia, hyperopia and astigmatism. Now with the advent of premium multifocal IOL lens implants the giant burden of presbyopia can now be corrected. Presbyopia affects a vast part of our aging population and often requires bifocal glasses. People in their mid forties that have trouble with reading are typically experiencing the first effects of presbyopia. Presbyopia is an accommodation problem with the lens of the eye. As the lens hardens and becomes inflexible with age it becomes more difficult to focus.

Traditional Lens Implants
Prior to the new premium lens implant technologies enabling people to see at all distances the only option for lens implants after cataract surgery was known as MONOFOCAL. This meant that the lens implant is only capable of one distance (FAR, MIDDLE, OR NEAR). For years patients would have monofocal lens implants but then require eyeglasses after Denver cataract surgery. In many cases patients would option for a good distance lens and just use glasses for reading or when needed in close proximity.

Before selecting your premium lens implant make sure to consult your eye doctor. Although one lens may appear better to you the guidance of your ophthalmologist is crucial in this decision making process. Before we examine your actual lens choices we are going to first discuss the function of the lens and the surgical process involved. Dr. Hines is conservative with his approach to lens implantation and will provide this option only if it is right for his patients.
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3. Cataract Surgery Process (Phacoemulsification)

The modern day cataract surgery technique is routinely performed with small incision microsurgery through a process known as phacoemulsification. The cataract removal and surgical process is actually done using the smallest possible incision, and removal of the lens material is accomplished using an ultrasonic probe. Before a new man made intraocular lens can be implanted the hardened cataract needs to be removed. After the eye is cleaned and proper dilation of the pupil has been achieved the surgeon is ready to make the incision. A micro-incision about the size of 3 millimeters is created at the junction of the cornea and the white part of the eye known as the sclera. The lens capsule is then opened and the ultrasonic probe is inserted so that the cataract can be removed. The ultrasonic probe pulverizes the cataract and suctions out the cataract material

After the cataract is removed the surgeon is ready to implant a man made intraocular lens. This is a crucial point of understanding for patients. Patients can either have a monofocal Medicare lens which will only correct vision for one distance or they can opt for an upgrade Multifocal IOL that can reduce or eliminate their need for glasses after cataract surgery. Please see our section below regarding lens implant options for more information about the tremendous lifestyle advantages that the premium lens implants offer.

The intraocular lens is a foldable lens that slides through a tube like a fruit roll-up and unfolds in the capsular bag. The surgeon may center the new lens with the lens capsule if necessary. Once the lens is centered, the surgery is complete. In most cases no stitches are required to seal the incision due specifically to the 3 mm size. This is why many eye doctors call it microsurgery.

4. Understanding what lens is right for you!

toricDepending on your specific vision needs, there are several types of multifocal lens implants that your ophthalmologist might suggest. Each of these lens implants (IOLs) works in a different way to help achieve vision correction goals. Ultimately, your doctor will know which lens is best suited for your eye. In order to get a better understanding of which lens options you may want to be familiar with we have separated the lens options into three categories.

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Lens Implants Options

Presbyopic Correcting Lens Implants

The ReSTOR® lens is an artificial lens implant that is designed to replace the natural lens of the eye. Made of a soft, flexible plastic material, the ReSTOR® lens has a patented design that allows it to focus light on the retina for clear vision at near, far, and intermediate distances. In just a few hours, the ReSTOR® lens can be inserted in the eye, then quickly and easily unfolded to restore vision during a brief visit to our Denver, Colorado office. The result is a remarkable improvement in both the quality (sharp, clear images at all distances) and quantity (a full range) of vision.

Who is a candidate for ReSTOR® lens implants?

The ReSTOR® lens is FDA approved for the treatment of cataracts. ReSTOR® lens implants are available at our Denver, Colorado eye center to all patients with cataracts and/or presbyopia (difficulty with close-up vision). The ideal candidate for the ReSTOR® lens is someone who is seeking better vision at all distances – near, far, and intermediate – without the hassle of glasses or contact lenses.

Accommodating Intraocular lenses

An accommodating intraocular lens is one that can move or change its shape in the eye. By doing this it changes its power so that it can focus from far to near. The only accommodating lens currently available is Crystalens made by Eyeonics. This is wonderful technology and is especially useful in those people who want the crispest distance vision as well as an excellent ability to see intermediate distance which includes things like computer, grocery shelves, auto gauges. In fact much of our time is spent looking at things in the intermediate range. Most people who receive Crystalens in both eyes are thrilled with the quality and range of vision. The one drawback of this lens is that some people will still need glasses for very close vision and when trying to read the smallest print.

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Toric IOL by Alcon

Many cataract patients suffer from astigmatism and have required glasses or contact lenses to drive or read for much of their adult lives. Toric lens implants correct for astigmatism when positioned in the eye. Toric IOLs are placed in the patient’s eye during routine cataract surgery just as the other intraocular lenses used at Hines-Sight.
In the same way that Toric contact lenses reduce or correct astigmatism, patients can receive Toric intraocular lens implants to restore sharper distance vision. When the eye’s natural lens (cataract) is removed and replaced with a Toric IOL, imperfections in the eye’s shape are improved, resulting in clearer vision without the need for multiple incisions, as is common in other astigmatism surgeries. In addition, recovery time is shorter and more comfortable than with older methods.

PRECAUTIONS: As with any type of surgery there are risks involved including disturbances and secondary surgical intervention. The effect on vision with the Alcon Toric IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases has not been studied.

5. Questions Regarding Intraocular Lens Implants

1. What types of people and distinct ages should consider an IOL?
ANSWER: Candidates for lens implants may vary from patients over the age of 40-45 to those suffering from cataracts. Most people seeking lens implants desire a full range of vision not just vision at one distance. Monofocal lens implants are typically not attractive to these candidates who desire this full range of vision.

2. Is lens implant surgery safe and what is the track record of success?
ANSWER: The process for inserting these premium lens implants is basically the same process as cataract surgery. SEE our detailed explanation in the above section regarding the surgical process. This process, known as phacoemulsification, has been performed for over 25 years and on millions of eyes.

3. Is there an additional cost to get a premium lens implant?
ANSWER: There is an additional cost with premium lens implants including multifocal, accommodating or toric lens implants. Medicare will pay the standard cataract fee and you will be expected to pay an additional charge for the lifestyle lens and related technical services. Please consult Dr. William Hines regarding these additional charges and he will be happy to explain the process.

4. When can I return to work or start regular lifestyle activities after this surgical process?
ANSWER: Please consult Hines-Sight doctors directly regarding post-operative Instructions. Many people can drive and return to work after only a few days. Your eyes may still be sensitive to light after the lens implantation process and sunglasses are recommended for outdoor activity.

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Our Denver, Colorado Cataract Surgeons

Our Colorado cataract surgeon, Justin P. Coco, D.O., looks forward to liberating you from the burden of cataracts! Please contact us to discuss your cataract surgery options, and see Colorado clearly again! If you would like more information about our exceptional physicians, visit their pages for more information on background and experience.

 
 

Harold Ridley

Did you know?

In 1949 Harold Ridley implanted the first intraocular lens in London England. (International Intraocular Surgery Club) By 1952 the first intraocular lens was implanted in the United States. It is amazing to think that lens implantation has been evolving for almost 60 years. For more historical information regarding cataract surgery please visit www.iiiclub.org

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2480 South Downing Street, Suite G-30, Denver, Colorado 80210

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