Cataract Surgery Has Come a Long Way

Surgeries are quicker, more precise and allow many patients to discard their reading glasses

By Deborah Jeanne Sergeant

Cataract surgery has become commonplace, but the techniques involved and results possible have improved over the past several years. Some patients may reduce their astigmatism and need for reading glasses, among other advances.

Largely associated with aging, cataracts affect many older people with yellow tinted vision, limited night vision, glare in bright light, cloudy vision and double vision. Mostly a routine surgery widely performed at out-patient centers and hospitals, cataract surgery has developed much in recent years.

“There are constant modifications and improvements to the intraocular manmade lenses that are inserted into the eye during cataract surgery,” said ophthalmologist Sandra Fernando Sieminski, director, glaucoma services in the department of ophthalmology, Jacobs School of Medicine and Biomedical Sciences at UB and an ophthalmologist with UBMD Ophthalmology/Ross Eye Institute.

“One of the big areas of development is the creation of a lens to help patients see at all distances — near, intermediate, and far. These lenses, called multifocal lenses, already exist, but they are continuously being improved.”

Instead of anticipating weeks of thrice a day drops, some surgeons offer no-drop surgery. While this may seem a minor advantage, it’s a big deal when a widow who lives alone delays surgery — and her chance for clear vision — because she feels uncertain about administering the eye drops afterwards. Plus, patients won’t have to pay for the drops, which can spare them three co-pays.

For drop-less surgery, “typically, an anti-inflammatory and antibiotic medication are injected into the eye,” Fernando Sieminski said. “This procedure is still not universally utilized, but may become a standard in the future.”

Laser cataract surgery has increased the surgeon’s precision in making incisions and breaking up the natural lens.

“This method of cataract surgery, in some cases, can help improve visual acuity outcomes, and help to remove difficult, dense cataracts,” Fernando Sieminski said. “Typically, the lens that is implanted to replace the cataract corrects patients’ distance vision, but they will need readers or ‘cheaters’ for reading vision. There are specialty lenses that can correct astigmatism — toric lenses — and others that can help correct near, intermediate, and distance vision all in one lens: accommodative or multifocal lenses.”

Though it’s not suitable for all patients, candidates can improve their near vision and astigmatism.

“Depending upon your needs and how bad your astigmatism is, these could be options for you,” said Kathleen Otto, representing Fichte Endl & Elmer Eyecare in Amherst and Niagara Falls and the new Ambulatory Surgery Center of Niagara.

Previously, people with small pupils challenged surgeons; however, a new advance has made treating them easier.

“The new pupil expander device, the iRing, assists the surgeon in small pupil cases,” said Ken Lindahl, ophthalmologist at Rochester Eye and Laser Center. “Small pupils are a known risk factor for complications during the cataract procedure.”