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Putting Cataract Surgery into Perspective

Cataract surgery is by far the most effective, and preferred, treatment for cataracts. In fact, more than 14 million cataract procedures are performed every year—making cataract surgery the most commonly performed surgical procedure throughout the world.

Typically, it takes an experienced eye surgeon just 15 to 30 minutes to remove a patient’s cloudy, cataract-obstructed natural lens, replace it with a new intraocular lens (IOL), and restore the eye’s ability to pass light rays to the retina for a clearer, better-focused image.

The main choices involve the method of cataract surgery and type of IOL.

Cataract Surgery Options

Today, two different methods of cataract surgery are available: Non-Laser Cataract surgery and Laser Assisted Cataract Surgery.

During Non-Laser Cataract Surgery, the eye surgeon uses a diamond or metal blade to manually perform all necessary incisions during the procedure.

In contrast, during Laser Assisted Cataract Surgery, a femtosecond laser system is used instead of a blade to precisely perform all of the required incisions.

Both methods rely on the same phacoemulsification technology, and ultrasonic waves, to help break up and remove a patient’s cloudy, cataract-obstructed natural lens.

Making the Right Choices

To better meet the needs of your specific eye health and lifestyle, Sharper Vision Centers offer a choice of several different types of replacement intraocular lenses (IOLs). The range of IOL choices, as well as their respective feature and benefits, are listed below.

Naturally, any decision regarding which type of cataract surgical procedure, and which replacement IOL, is best for you should only be made in consultation with Dr. Oyakawa—and only after a thorough review of your specific eye health, lifestyle, and personal preferences.

Standard cataract surgery is covered by insurances but requires glasses after surgery. Patients who undergo cataract surgery with standard IOLs experience presbyopia. Standard IOLs are monofocal lenses that cannot focus both for distance and near. They also do not correct astigmatism and if left uncorrected vision will be reduced. Glasses will correct the astigmatism and presbyopia.

Laser Assisted Cataract surgery is not covered by insurance. We use this advanced technology for our astigmatism and presbyopia correcting surgeries.

REFRACTIVE CATARACT SURGERY OPTIONS

Astigmatism and refractive error correction

Many people receiving cataract surgery also have a condition called astigmatism. If you have astigmatism, your cornea is irregularly shaped. Instead of being shaped like a basketball, it is shaped like a football. Astigmatism causes rays of light entering though different parts of the eye to focus unequally so that they never form a single focus. As a result, things look blurry because images are not focused clearly on the retina. Untreated, astigmatism requires glasses or special contacts.

Patients will have good distance vision and will need inexpensive readers for computer and reading. Any refractive errors are corrected.

Presbyopia-correcting options (refractive error and astigmatism also corrected)

If you have trouble reading up close, you may have presbyopia. Since most people with cataracts also have presbyopia, the good news is that both conditions can often be treated at the same time.

Several types of IOLs are available for correcting presbyopia. The presbyopia-correcting solutions offered at Sharper Vision Centers are listed below. Decisions about which procedure is best for you should be made in consultation with Dr. Oyakawa. The right presbyopia solution for you will depend on your eye health, lifestyle, and personal preferences.

Learn more about Presbyopia.

Accommodative IOLs

These lenses use the muscles of the eye to change the shape of the IOL, similar to a slightly presbyopic eye. Unlike multifocal IOLs, they do not split light between various focal points to achieve presbyopia correction.

CrystalensAO™ IOL is designed to move forward and backward, like the natural lens of a young, healthy eye. Dr. Oyakawa received the Crystalens® Center of Excellence award in January 2008. He also has a Crystalens AO in one eye. Learn more about CrystalensAO™ IOLs.

This demonstrates the movement of the CrystalensAO™ IOL
as it focus from distant to near objects.


Rollover Image to View

Advantages of CrystalensAO™

  • Higher quality of vision compared to multifocal IOLs because light is not split between different focal points. Resulting in less glare and halos.
  • Excellent distant and intermediate vision, some patients may need inexpensive readers for prolonged reading.
  • Excellent for patients who do a lot of work on computers

Disadvantages of CrystalensAO™

  • Some patients may not recover muscle function to achieve enough accommodation to perform near tasks and need to use inexpensive readers.
  • Eyes are dilated for a few days after surgery to set the Crystalens in the correct position.
  • Readers are needed for two weeks after surgery to set the Crystalens in correct position.
  • Eye exercises are required to recover muscle function for accommodation.
  • More post operative visits are needed to monitor to progress.

Multifocal IOLs

These lenses have rings of different optical powers, similar to trifocal or progressive glasses, which bring distant, intermediate, and near objects into focus at the same time.

AcrySof® ReSTOR® Aspheric IOL and Tecnis® Aspheric Multifocal IOL are designed to provide quality vision throughout the entire visual spectrum—near through distance.

Advantages of AcrySof® ReSTOR® Aspheric IOL and Tecnis® Aspheric Multifocal IOL

  • Offers better depth perception than monovision.
  • Excellent near vision and distance vision.
  • Decreases or eliminates the use of glasses.

Disadvantages of AcrySof® ReSTOR® Aspheric IOL and Tecnis® Aspheric Multifocal IOL

  • Splits light into multiple images, reducing the quality of vision and inducing glare.
  • More halos and glare compared to monofocal IOLs, although most patients adapt. A few patients do not adapt and have difficulty driving at night.
  • Due to the bifocal design, intermediate vision (computer, cooking, etc.) is not as good and may require readers.
  • Near vision is dependent on the pupil size and in dim light, such as a restaurant, near vision is reduced.
  • Some patients are not candidates for this lens due to large pupils or certain types of eye diseases.
Light Rays
Monofocal, Crystalens, focuses light to a single point A monofocal IOL, such as the Crystalens, focuses light to a single point.
Diffractive multifocal, ReSTOR, splits light into two main images A diffractive multifocal IOL, such as the Restor®, splits light into two main images.

Monovision with aspheric Monofocal IOLs

Monovision is a strategy in which vision is optimized for one particular distance. Conventional (spherical monofocal) IOLs have been used to treat cataracts for over 30 years. Replacing the cataract with a conventional lens implant greatly improves vision at a single focal point (usually distance) but generally requires the use of reading glasses or bifocals for close-up and intermediate range vision. In some cases, the eyes are implanted with different lenses—one for near vision and one for far.

Advantages of aspheric IOLs for monovision

  • Cost effective treatment for previous successful monovision patients. These lenses are covered by Medicare and private insurances. Any existing astigmatism needs to be corrected for best results/vision (we recommend the laser assisted cataract surgery).
  • Decrease or eliminate the use of glasses.

Disadvantages of aspheric IOLs for monovision

  • Binocularity (use of both eyes) is reduced for viewing objects.
  • Decrease in depth perception (ability to judge distance).
  • A compromise between good depth of field and decrease in use of glasses.
  • A few patients may need to use glasses for night driving or prolonged computer work and reading.
  • Some patients use one disposable contact lens in their near eye for good binocular vision during sports, such as tennis.
  • In rare situations, some patients may decide to have the eye with near vision corrected to allow distance vision.

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