What is a cataract?
The transparent human lens, like the lens of a camera, focuses light rays onto the retina (the camera "film"). A cataract is any opacity in the lens that interferes with light transmission through the eye resulting in decreased visual function. Clinically, this is manifested as "blurred vision", "cloudiness of vision", "poor night vision", or "glare."
What are the symptoms of cataracts?
In addition to painless blurring of vision, patients complain of cloudy vision, poor night vision, glare, light sensitivity, and a yellowish discoloration or drabness of colors.
In some patients, the progression of the cataractous lens acts like a "reading lens" and may temporarily give some patients better near vision, a phenomenon called "second sight". This "improvement in vision" of course, is only temporary as the vision later worsens with further cataract progression. When this occurs, persons with cataract will have worsening symptoms negatively affecting even activities of daily living. What are my options for treatment?
The Old Ways:
Until recently, cataract surgery involved a very large incision in the globe to remove the lens in toto (intracapsular cataract extraction or ICCE), or leaving the posterior capsule behind to support an intraocular lens or IOL (extracapsular cataract extraction or ECCE). Both techniques require several sutures to close the wound, and are performed under general anesthesia or retrobulbar anesthesia (anesthesia injection behind the globe), taking anywhere from 30 minutes to an hour to perform. In ICCE, hardly performed in developed countries today, patients need to wear very thick glasses after surgery to compensate for the natural lens that was removed. Although more advanced than ICCE because an intraocular lens or IOL can be implanted inside the eye, ECCE still has major disadvantages associated with a large wound. In spite of these disadvantages, many ophthalmologists in the country today still perform cataract surgery via ECCE. Modern-day Cataract Surgery: Phacoemulsification State-of-the-art cataract surgery involves a very small incision (less than 1/8th of an inch) in the cornea wherein a probe is inserted with the purpose of breaking up the cataract and removing the pieces by aspiration. This procedure is called phacoemulsification and is more familiar to the lay person as "no-stitch" or "stitch-less" surgery. AEC surgeons not only were the pioneers in this type of surgery in the Philippines but continue to remain in the forefront in it's innovation, improvement and instruction both nationally and internationally. The American Eye Center likewise settles for nothing less than the best and latest in technology using the remarkable Alcon Infiniti Vision System. As the small incision in phacoemulsification is self-sealing, no sutures are needed. A relatively recent technological advancement, the "foldable" IOL" (see discussions below) is inserted through this incision, preserving the small size and self-sealing nature of the wound. The whole process is done under "eyedrop anesthesia" and is usually completed in 15 minutes or less. Because of the elimination of the need for general or injection anesthesia, the absence of bleeding and eye covers ("patching"), and the almost instantaneous (within hours after surgery) return of good visual function even without glasses, phacoemulsification is commonly but erroneously referred to as "laser eye surgery." While this procedure is currently the standard for cataract removal worldwide, it is NOT laser cataract surgery. True laser removal of cataracts was previously unavailable to patients, until very recently (see next section on femtosecond cataract surgery). Phacoemulsification is routinely performed at the American Eye Center and is available as a surgical option for our patients with cataracts. Femtosecond Cataract Surgery: A new treatment for cataracts was recently unveiled at the American Eye Center that promises to provide patients with the most advanced all-laser cataract procedure---the first of its kind in Asia. Dubbed the Alcon LenSx femtosecond laser surgery, this new equipment brings an unprecedented level of safety, speed and precision in treating cataracts, and enhances the host of options for surgical-based methods that AEC offers its clients. The Alcon LenSX femtosecond laser differs from the traditional methods of cataract surgery by the absence of the blade. By using very short yet intense bursts of near-infrared light, the Alcon LenSX femtosecond laser technology is able to create extremely precise subsurface cuts without manual intervention The blades used to create the small incisions in the eye have been completely replaced by this laser, making the incisions more precise and predictable. In addition, the circular opening that is created in the human lens in order to access the cataract (called a capsulotomy) which was traditionally performed by human hands has now been replaced by the femtosecond laser, making the capsulotomies more architecturally round and centered. Studies have shown that this is very important in intraocular lens stability and refractive predictability of surgical outcomes (In one study by the American Academy of Ophthalmology, femtosecond laser incisions achieved perfect capsulotomy diameter accuracy in 100 percent of cases). Finally, the actual cataract is also fragmented by the femtosecond laser making it much easier and less traumatic for the surgeon to remove and clean it up prior to placement of the IOL. In short, the femtosecond laser has replaced many of the steps in the cataract surgery that were previously performed by human hands, i.e., resulting in less surgical error and better predictability of outcomes. Results are more precise than any other previous or current methods of cataract surgery. The Alcon Lensx Laser system is currently available ONLY at the American Eye Center. Arguably the most advanced method for cataract surgery today, it is now readily available in our center as one of the surgical options for cataract surgery. |
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