Cataract

Cataracts do not always interfere significantly with vision. They start small and are almost imperceptible to the patient. If a cataract progresses to the point that vision is impaired or lifestyle is affected, it should be removed. If it remains stable, surgery may not be necessary. Be sure to have regular comprehensive vision check ups with your eye doctor to monitor cataract progression so that, together, the decision to have cataract surgery can be made.

While existing cataracts cannot be reversed, it is possible that wearing quality sunglasses with UV (ultraviolet) protection can slow down the progression of a cataract. Eating a healthy, balanced diet that includes antioxidant vitamins is thought to help prevent the formation of cataracts. Ask our eye doctors more in-depth questions during your visit.

During cataract surgery, your surgeon will use a local anesthetic (numbing eye drops) to keep you from experiencing pain during your procedure. You will also be given a mild sedative to help you relax. Depending on the patient and type of procedure, additional medication may be utilized. As the medications wear off, you may feel a scratchy sensation or slight soreness in your eye the first day. Over-the-counter pain relievers can be used to alleviate discomfort. If necessary, your doctor will prescribe stronger pain medication.

Cataract surgery is typically performed on one eye at a time to allow the surgeon to evaluate the outcome of the first procedure before operating on the other eye. This evaluation may affect the choices made for the second surgery, especially in cases using an accommodative or multifocal lens. Also, cataracts are removed individually as a precautionary measure, in case the eyes were to become infected or have any other rare complication. Even a slight risk of both eyes becoming infected is reason enough for doctors to recommend separate surgeries. Additionally, cataracts do not always progress at the same pace, therefore surgery may not be required at the same time.

When left untreated, cataracts typically worsen and vision continues to be reduced. Eventually, untreated cataracts can cause legal or even total blindness. In most cases, implantation of the intraocular lens will restore vision, however, advanced (or hyper-mature) cataracts can be more difficult to remove and have a higher risk of complications.

In the context of health insurance, including PPOs, HMOs, and Medicare, the coverage typically extends to standard lens implants, which are considered medically necessary. However, upgrades to the LAL are not covered because they are deemed not "medically necessary." This means that while the basic treatment or procedure is covered, any additional cost for the LAL would be an out-of-pocket expense for the patient. LAL offers additional benefits or features, but since they are not essential from a medical standpoint, insurance plans do not cover their extra cost.

Candidates for the Light Adjustable Lens (LAL) treatment are typically individuals who meet the following criteria:

• Have cataracts: LAL treatment is primarily used to replace the eye's natural lens that has become clouded due to cataracts.
• Moderate amount of astigmatism: Patients with a moderate level of astigmatism can benefit from the customizable nature of LAL to correct this refractive error.
• Desire for reduced dependence on glasses or contacts: Those looking to decrease their reliance on corrective lenses for distance and near vision may find LAL appealing because of its adjustability post-surgery to refine visual outcomes.
• Previous vision correction procedures: Patients who have undergone previous vision correction surgeries like PRK or LASIK may also be good candidates, indicating that their eyes can tolerate surgical interventions.

However, certain conditions exclude individuals from being suitable candidates for LAL  treatment:

• Herpetic eye disease: Patients with a history of herpetic eye disease are not considered good candidates due to potential complications or risks.
• Medications increasing sensitivity to UV light: Since LAL adjustments are made using UV light, patients on medications that heighten UV sensitivity may face adverse effects and are thus not ideal candidates.

In summary, ideal candidates for LAL are those with cataracts and moderate astigmatism seeking less dependence on glasses or contacts, including those who have had prior refractive surgeries, but excluding individuals with conditions that pose risks during the LAL adjustment process.

Typically, between three to four ultraviolet (UV) light treatments are needed to refine and finalize the vision correction with LAL technology. The exact number of treatments depends on how well the patient's vision responds to the adjustments. The process involves assessing the visual outcomes after each treatment and determining if additional adjustments are necessary to achieve the best possible vision. Once the optimal vision correction is attained, as agreed upon by the patient and the doctor, the final adjustment is made, and the prescription is locked in. In some cases, further improvement might not be possible or necessary after a certain number of treatments, so additional light treatments would not be beneficial.

If you do not wear UV protective eyewear after receiving a LAL implant, you could inadvertently expose the lens to ultraviolet light, which can prematurely adjust the lens power. This unintended exposure can lead to incorrect vision correction, potentially worsening your vision instead of improving it. As a result, the LAL might need to be removed and replaced with a standard lens implant, necessitating additional surgery. This not only increases the risk of complications associated with undergoing another surgical procedure but also negates the benefits of the adjustable lens. Therefore, wearing the prescribed UV protective eyewear as directed by your doctor is crucial to ensure the success of the LAL treatment and avoid these negative outcomes.

You should wear UV-blocking eyewear continuously until your eye doctor advises that it is safe to stop, which is typically 24 hours after your final light treatment. The total duration of wearing these glasses usually extends to about 4 to 5 weeks. However, this period can vary based on the number of light treatments you receive. Eyewear is essential to protect your eyes from accidental exposure to UV light, which could prematurely adjust the Light Adjustable Lens (LAL) and affect the outcome of your vision correction. Following your doctor's instructions regarding the use of UV protective eyewear is crucial for the success of the LAL treatment.

No, regular sunglasses with UV protection are not sufficient after receiving a Light Adjustable Lens (LAL) treatment. The UV-blocking glasses provided to you for post-LAL treatment have a special protective coating designed specifically to block the type of UV light that can affect the adjustable lens. These specialized glasses offer a higher level of protection needed to prevent any premature changes to the LAL. Therefore, it is important to use specific eyewear given to you by your eye care professional to ensure the success of your lens adjustment process and avoid unintended alterations to your vision correction.

While the Light Adjustable Lens (LAL) treatment aims to provide optimal vision correction, no eye surgery, including LAL, can guarantee 20/20 vision for every patient. The outcome of any eye surgery, including LAL, depends on several factors, such as the health and condition of the patient's eyes, the presence of other eye-related issues, and the individual's response to the surgery. The LAL offers the advantage of allowing post-operative adjustments to the lens power, which can lead to a more precise correction of vision compared to standard lens implants. However, the exact level of vision improvement, such as achieving 20/20 vision, cannot be guaranteed and varies from person to person.

The Light Adjustable Lens (LAL) procedure is designed to minimize the dependence on glasses or contact lenses after cataract surgery by allowing for precise adjustments to the lens implant after the operation. This can significantly improve vision accuracy and reduce the need for corrective eyewear. However, it does not guarantee complete independence from glasses or contact lenses for every patient. The necessity for glasses after LAL surgery can depend on several factors, including the individual's specific vision needs, the presence of any residual refractive errors, and how the eye heals and responds to the surgery. Some patients might still need glasses for certain activities, such as reading or driving, especially if they have multifocal needs or if there is a slight imperfection in vision correction.

Unfortunately it does not.  Health insurance, including PPO’s, HMO’s, and Medicare, covers a standard lens implant.  Upgrades to special implants are not ‘medically necessary’.

This multifocal lens provides a range of focus from distance to near.  Over 90% do NOT need glasses most of the time.  Be prepared to need glasses for certain lighting or for reading smaller print.

Most people with the trifocal lens implants enjoy the convenience of performing simple near tasks without having to put on reading glasses.  Examples include looking at cell phone, a photo, a menu, a boarding pass, an envelope address, a handwritten note, a price tag or a receipt.

How often an individual requires glasses varies.  It is impossible to know in advance how often YOU will “need” glasses, but in general, it is much less with this lens.

Night time halos and difficulty with night driving can be an issue.  However, experience has shown that this is an uncommon problem.  If you experience serious halos, then you may require additional surgery.

Yes, this is possible when the other eye already has a conventional implant, or when there is no cataract in the opposite eye.  However, the ability to see both far and near without glasses is better when you have a trifocal lens in both eyes.

Unfortunately it does not.  Health insurance, including PPO’s, HMO’s, and Medicare, cover a standard lens implant.  The fee to upgrade the lens implant is not covered because having less astigmatism is not ‘medically necessary’.

If a cornea is perfectly round like a basketball, then it has no astigmatism.  On the other hand, if a cornea is not perfectly round, then there is astigmatism.  An egg or a football would be an example of surfaces with astigmatism.

With standard lens implants, the astigmatism in the eye is unchanged after cataract surgery.  It’s like getting a pair of glasses without all the correction built in.

A toric lens implant corrects for the astigmatism in the cornea.  It’s like getting the correct pair of glasses.

Both the standard lens implant and the toric lens implant are “single-focus”.  This means that after cataract surgery you will need to wear reading glasses to see clearly at near.