Cataracts are one of the most common age-related vision conditions impacting Americans. Over 25 million people have cataracts, and this figure is expected to rise over the next few decades. While cataracts account for more than 50 percent of all blindness cases worldwide, you don’t have to lose your eyesight from this condition. Cataract surgery offers you a safe and effective way to restore clear vision.

During a free lecture, Dr. Kevin Cuevas, a board-certified, fellowship-trained cornea specialist with Boulder Eye Surgeons, discussed recent advances in cataract surgery, including laser cataract surgery — a procedure that improves the precision and accuracy of cataract removal and potentially reduces the need for glasses.

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VIDEO ALERT: Watch Dr. Cuevas' lecture on "Advances in Cataract Surgery."
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What are Cataracts?
A cataract is a clouding in the lens of the eye. As a cataract forms, your lens will become increasingly opaque, resulting in faded, blurry and dim vision that progressively becomes worse over time.

“Almost everyone will develop cataracts as they grow older,” said Dr. Cuevas. “Typically, most people in their late 50s and certainly the vast majority of people in their 70s will have developed visually significant cataracts."

Common symptoms of cataracts include:
• Bright colors become dull
• Halos around lights
• Difficulty reading in low light
• Blurred or double vision
• Frequent change in glasses prescription
• Increasing nearsightedness

Treatment Options for Cataracts
During the early stages of cataract development, Dr. Cuevas recommends watching the cataract. “If your vision is still good, you may not need cataract surgery. We do cataract surgery when it affects your lifestyle,” he explained.

According to Dr. Cuevas, prescribing stronger glasses is often a viable option to treat cataracts as they start to develop. Once this no longer effective, surgically removing the cataract, along with intraocular lens (IOL) placement, can help restore clear vision.

Dr. Cuevas also explained that the goals of cataract surgery today are much different than they were several decades ago. Back then, cataract surgery patients required glasses to see clearly after their procedure. However, the primary goal today is to increase the chances of freedom from glasses with a quality range of vision.

“More people are interested in getting rid of glasses if they can, and this is the goal of refractive cataract surgery today,” said Dr. Cuevas.

Cataract Surgery Basics
Cataract surgery is one of the most common procedures performed in the U.S. It also is one of the safest and most effective types of surgery.

The surgery is quick (often taking less than 10 minutes), painless, performed without admission to the hospital and does not require general anesthesia.

Most modern cataract procedures involve the use of phacoemulsification — a high-frequency ultrasound device that fragments the cloudy lens into small pieces. “The pieces are then gently removed from the eye with suction through tiny microincisions. We then replace the cloudy lens with an artificial intraocular lens implant, or IOL,” Dr. Cuevas explained.

Laser Cataract Surgery
According to Dr. Cuevas, lasers have become an integral component to cataract surgery:
• Lasers assist the surgeon in some of the most delicate steps during the procedure.
• Lasers allow for more precise treatment of astigmatism than is possible when incisions are created manually. “This is important for patients who want to no longer wear glasses. It’s critical that we mitigate corneal astigmatism,” said Dr. Cuevas.

"The femtosecond laser is a significant improvement compared to previous cataract surgery technology,” said Dr. Cuevas. “It ensures the most predictable post-operative results, helping to reduce the need for thick glasses or a contact lens after surgery."

He then explained how the femtosecond laser can help in the cataract surgery process:
• The laser allows for customizable precision during the creation of incisions.
• Fragmentation of the cataract by the femtosecond laser reduces the amount of phacoemulsification energy delivered during cataract removal, resulting in less corneal edema (swelling caused by excess fluid) and inflammation.

IOL Options
The type of IOL used with your procedure will have a significant impact on the quality of your vision after surgery. There are four different categories of IOLs:
• Monofocal
• Toric
• Multifocal/EDOF (extended depth of focus)
• Accommodating

As the name implies, monofocal lenses are only able to focus at one distance. You have three options with a monofocal lens:
• Distance vision will focus clearly
• Near vision will focus clearly
• Monovision (one eye is set for distance vision and the other eye is set for near vision in order to eliminate the need for reading glasses)

Toric IOLs correct for higher levels of astigmatism. “Lower levels of astigmatism can be corrected with a laser, but when we have patients with a higher level of astigmatism, we move to a Toric lens,” explained Dr. Cuevas.

Multifocal IOLs fall under the premium lens category. These offer quality vision at all distances. Some of the multifocal IOLs have been associated with halos at night. However, Dr. Cuevas has found that halos haven’t been an issue with his patients when he uses the Tecnis Symfony lens.

Accommodating IOLs shift as your eye moves and changes focusing power as you look at distant or near objects. “This type of lens provides good distance and intermediate vision. However, near vision typically requires reading glasses,” said Dr. Cuevas.

View PowerPoint slides from Dr. Cuevas’ cataract surgery lecture:

To make an appointment with Dr Cuevas, call Boulder Eye Surgeons at (303) 444-3000

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