Cataract Extraction (CE) and Intraocular Lenses (IOL)

A cataract is the clouding of the normally clear lens of the eye. The lens focuses the light entering the eye onto the retina so that the visual stimulus can be processed by the brain. When the lens becomes cloudy, the vision can decrease and/or patients can experience glare and halos. Cataracts cannot be removed or treated with eye drops, lasers, medications, or changes in diet. Cataracts are removed using a technology called phacoemulsification. Sound waves break up the cloudy lens into tiny pieces and these pieces are gently vacuumed out of the eye through small incisions. This is often done without requiring sutures. Once the cataract is removed, typically an intraocular lens (IOL) is implanted to focus the light onto the retina. This is typically placed behind the iris and the pupil. There are various types of IOLs available depending on the patient’s needs. This is generally an outpatient procedure.

Types of IOLs

Standard (monofocal) IOLs

This is a popular option selected by many patients. If distance vision is the goal, the patient will likely require reading glasses or bifocals for near work. If monovision is chosen, one eye will be set for distance and the other for near. Glasses may be needed in some situations. Depending on the patient’s insurance, there is typically little out-of-pocket cost for these IOLs.

Smart IOLs

Astigmatism-correcting IOLs - These IOLs have a design similar to the monofocal IOLs except that the focusing element can correct astigmatism. Astigmatism occurs when the cornea has different curvatures in different directions. This is usually the IOL of choice for patients with higher degrees of astigmatism. There is an out-of-pocket cost for this type of IOL.

Multifocal IOLs - These IOLs are a great option for reducing a patient’s dependence on glasses and contact lenses. They work by providing simultaneous near and distance vision in each eye, thus allowing both eyes to work together for both distance and near. There is an out-of-pocket cost for this type of IOL.

Accommodating IOLs - This is a flexible IOL that in many patients provides both distance and intermediate vision. There is an out-of-pocket cost for this type of IOL.

We specialize in complicated cataract surgeries as well. These include cataract surgeries in patients with a history of previous refractive surgery (LASIK, PRK, or RK), traumatic cataracts, and/or dislocated lenses.

Intraocular Lens Exchange

Occasionally, a previously implanted IOL may need to be removed and/or exchanged with a new intraocular lens. This can occur if the IOL power is not sufficient, if the IOL is malpositioned, or if the IOL cannot be tolerated by the patient. This is performed by making small incisions in the front of the eye, removing the IOL, and hopefully replacing it with a new IOL. This is generally an outpatient procedure.

Yag Capsulotomy

A “secondary cataract” is cloudiness in the back membrane that holds the intraocular lens in place. This can occur anytime after cataract surgery, but usually 1-5 years after surgery. Yag posterior capsulotomy involves making a small opening in the posterior capsule using a laser. This is done without an incision. This is an outpatient procedure.