The human lens in the eye is normally crystal clear, but when it becomes opaque, we call it a ‘cataract’. A cataract is NOT a film or growth that occurs in the eye. It is simply a cloudy lens. As the cloudiness worsens, it prevents light from properly focusing in the eye. Early lens changes or opacities may not disturb vision significantly. But as the lens continues to change, the vision becomes blurred and the person notices glare, haziness, and difficulty with seeing street signs or reading, for example.
Who gets cataracts?
Like gray hair, cataracts are basically unavoidable. For most people, cataracts in the form of slight lens opacities start to develop in their 50s and surgery is typically performed in their 50s, 60s, and 70s. For nearly all patients, the cataracts are related to age, lifetime sun exposure, and genetics. In the other patients, the cataract may be related to diabetes, steroid use (for asthma, allergies, or immune problems), or trauma. Cataracts are a leading cause of blindness but, fortunately, cataracts are easily treated and cured. Everyone who lives long enough will end up having cataract surgery, and this explains why it is the number one surgery performed in the USA, with about 3 million performed last year.
You’ll need to have a thorough examination of your eyes, including dilation and an attempt at a new glasses prescription. At first, a change in your eyeglass prescription may be all that is needed to temporarily improve your vision. When you feel that your vision affects your daily activities or your lifestyle and you desire better vision, cataract surgery should be considered. Cataracts can only be removed with surgery.
Why Dr. Keyhani?
I will perform your surgery the same way that I would perform it on my own family members. Your eyes are your most precious sense, and I treat them as such. Many physicians, surgeons, eye doctors, nurses, and their families have chosen me as their surgeon for this reason.
- No Pain. The vast majority of my patients report no pain and don’t even take a single Tylenol afterwards. I am able to numb the eye with eye-drops, while the anesthesiologist gives a small amount of sedation in the intra-venous line to help you relax.
- No Stitches and No Bleeding. Since my incision is so tiny (about 1/8th of an inch) and it seals by itself. It is placed in such a manner that not even one drop of blood comes from the incision. Other techniques require incisions 2x to 5x larger than this, using a large steel blade or even scissors in the eye. In these older techniques, the surgeon would then place between one and ten nylon stitches to close their larger incision. These nylon stitches are sometimes felt when you blink, and they are often left in the eye for years or even permanently. Recovery after this less advanced type of surgery is months, versus just a week or two after my surgery.
- The Best Optics. The best vision requires the best optics. This involves choosing the best intra-ocular lens to implant in your eye. The cost of the best lenses is many times more than the cost of the cheaper lenses, and in some surgical centers, corners are often cut. I never cut corners, and I only implant the best lenses. In addition, I perform exacting calculations to determine which power lens to place in the eye. I take the extra time to incorporate as much of your glasses prescription as possible, into the power of the implanted lens. I can even analyze your eye and make my tiny incision in such a manner as to help to reduce your astigmatism. All of this means you’ll be far less reliant on glasses after the surgery, and most patients don’t wear glasses for distance vision, such as driving.
- Experience with Advanced Techniques. My focus is state of the art cataract and lens surgery. I perform the most advanced techniques and teach them at the prestigious New York Eye and Ear Infirmary, one of the premier eye surgery training institutions in the world. In order to make the surgery as gentle as possible, your surgeon should use the most advanced techniques.
How successful is cataract/lens surgery?
In my hands, cataract and refractive lens surgery has a success rate of more than 99%. I am very vigilant about infections and I’ll have you use special antibiotic eye drops before and after your surgery. In addition, everything is fully sterilized for your surgery, and absolutely no expense is spared. Remember, that this is a real surgery on your eyes, and your success depends directly on your surgeon’s skills.
So why don’t all surgeons perform this Advanced Clear-Corneal method?
Cataract surgery is not an easy surgery to perform, and no surgeon is born knowing how to perform it well. The surgery is performed while the surgeon looks through an operating microscope that greatly magnifies the view of the eye. This also means that a very steady hand is important. It is easier to perform the older techniques of cataract surgery, rather than learning the newer technique. Like any other highly technical task, it requires natural talent and considerable practice, at least a few hundred surgeries. Some eye surgeons are sharp and are able to learn some of the newer techniques. However, there are still surgeons who still perform out-dated types of surgery, and uninformed patients don’t realize the difference until it’s too late.
Lens replacement choices
Until just a few years ago there were very few choices when it came to intraocular lens implantation. Remember that when a cataract is removed, a new artificial lens in inserted into the eye to replace it. In recent years, their have been exciting new developments in the field of intraocular lenses and patients now have a choice in which lens they would like to have placed in their eyes. Depending on the measurements of your eyes, you may be a candidate for one of these new premium lenses. Some will allow you to see without glasses at far and some will even allow you to see both at near and far without glasses the majority of the time. Dr. Keyhani will go through these options with you and fully explain if you are a candidate for these lenses.
Premium lens choices:
Toric IOLs are specially designed for patients with astigmatism. Traditionally, surgical correction of astigmatism required making a series of small incisions called Limbal Relaxing Incisions (LRI) around the cornea to make it more spherical instead of football-shaped. Implanting toric IOLs often improves vision due to astigmatism without the need for these extra incisions, and also allows patients to enjoy a faster, more comfortable recovery.
Multifocal/Extended Depth of lens: Panoptix/Vivity
Aspheric Panoptix and Vivity
Traditionally, when a cataract develops, the eye lens is replaced with an artificial intraocular lens (IOL). The lens is usually focused for distance vision, requiring that the patient need to wear reading glasses or contact lenses to focus in on nearer objects.
Through recent advancements in lens technology, an IOL is now available that can provide the patient with a greater range of vision while reducing the need for glasses and contacts. The Panoptix and Vivity intraocular lens provides a full range of functional vision for patients that desire a significant decrease in their dependence on glasses or contacts.
Laser cataract surgery.
The LensSx® Laser is designed to deliver femtosecond precision to Refractive Cataract Surgery. The LenSx® laser automates most challenging steps of traditional cataract surgery, providing image-guided, surgeon control to perform anterior capsulotomy, lens fragmentation, and all corneal incisions.
At At Keyhani Eye Associates, we are proud to be able to provide you with Laser Refractive Cataract Surgery with the Femtosecond LenSx® Laser from Alcon – the next evolution in cataract surgery. This advanced technology provides image-guided, surgeon controlled anterior capsulotomy, lens fragmentation and all corneal and cataract incisions. The LenSx® laser will allow us to pre-cut the nucleus to allow for a safe and more precise cataract surgery.
LenSx® Femtosecond Laser Technology
- Improved accuracy of all incisions
- Predictability at every step
- True image-guided intraocular surgery
- Opportunity to create optimal wound architecture
- Precise capsulotomy design for every intraocular lens (IOL)