Did you know that the famous Impressionist artist Claude Monet suffered from cataracts late in life? As his natural lens turned yellow and then brown, clouding his vision, his paintings changed from being bright and colorful to looking dark and muddy. He postponed having cataract surgery until he was nearly blind because the procedure was considerably more dangerous in the early 1900’s. After he could see clearly again, Monet was horrified by the dark paintings he had made while his vision was clouded by cataracts, and he ended up destroying many of them.
Fortunately, cataract surgery is far safer today and is performed as an outpatient procedure. Dr. Price achieves excellent results just using eye drops to numb your eye – he doesn’t use any injections around your eye. Also, he makes a very small incision and doesn’t use sutures or “stitches” for routine cataract surgery.
Dr. Price and the Cornea Research Foundation are working actively to make cataract surgery ever easier and safer for patients. Recently, we evaluated new eye drops to reduce pain and inflammation, and we’ve tested new antibiotic eye drops to help prevent infections. We’ve assessed intraocular lenses that filter high energy blue light as well as ultraviolet light to better protect the back of your eye. Also, we’ve shown that use of a small ring-shaped device improves safety in high-risk patients when the fibers holding the lens in place are loose or damaged.
Beyond just improving safety, we are also working to give cataract patients even better visual results. For example, we recently tested an exciting new intraocular lens that can be fined tuned with a light beam after it has healed into place in your eye.
What are your lens options for cataract surgery?
Monofocal: Patients receiving monofocal, or single focus IOL, generally will experience excellent vision but will need glasses for either intermediate/near or distance depending on patient’s choice and visual goal.
Multifocal: Patients choosing multifocal lenses usually experience a greater independence from glasses and contacts. Multifocal lenses incorporate correction for both distance and near vision.
Astigmatism Management: If you have cataracts and astigmatism, your astigmatism management options include corneal relaxing incisions or laser refractive surgery. Typically, you will need to wear reading glasses or bifocals following your procedure.
Toric: A toric lens is designed to correct higher amounts of astigmatism in cataract surgery. Most patients receiving a toric lens enjoy excellent distance vision, but still may need readers or bifocals.
With cataract surgery we strive help people select a lens that will give each person the best possible vision without glasses. Since we see many people who have cornea problems, such as Fuchs’ dystrophy, in addition to cataracts, we frequently combine cataract surgery with a cornea transplant to treat both problems at the same time. However, Fuchs’ dystrophy causes the cornea to swell and change shape, and this makes it a lot harder to figure out exactly what lens power to place in the eye when the cataract is removed.
Therefore, we are now using a special imaging device to carefully characterize how the shape changes in Fuchs’ dystrophy corneas following a transplant. Dr. Price is one of the few transplant surgeons in the country using the minimally invasive transplant procedure known as DMEK, in which a single cell layer on the back of the cornea is exchanged for healthy donor tissue. With DMEK we don’t have any thickness variation in the donor tissue, so we can focus on just better understanding how the patient’s cornea changes. We appreciate our many donors who support our efforts to give each patient the best possible vision and the safest possible surgery!