Cataracts

If your vision is cloudy, you have difficulty seeing well at night, or headlights appear too bright, you may have cataracts. Cataract surgery can give you optimally clear vision and reduce your need for glasses. Cataract surgery is the most common surgerical procedure in the US.

Trusted eye surgeon Dilys Bart, MD, has exceptional surgical training, skill, and experience. Dr. Bart has advanced expertise in sutureless and small incision cataract surgery, femtosecond laser-assisted cataract surgery, Optiwave Refractive Analysis, and premium intraocular lens technology, including light adjustable, multifocal, toric, accommodating, and extended depth-of-focus lenses. For your best vision, schedule a cataract evaluation at The SF Vision Center by phone or request one online today.

Cataracts

Contents:

What are cataracts?

What are symptoms of cataracts?

When should you have cataract surgery?

What happens before cataract surgery?

What happens during cataract surgery?

What happens after cataract surgery?

Complications

Intraocular lenses (IOLs)

What is laser cataract surgery?

What is Optiwave Refractive Analysis (ORA)?

What are cataracts?

A healthy eye has a clear lens inside. The lens focusses images by bending light rays in the eye. A cataract is a clouding of the lens. It is caused by the breakdown and clumping of normal proteins.

This process typically starts after age 40. Cataracts are quite common as you get older. In fact, almost half of Americans have a cataract or have had cataract surgery by age 75.

During surgery, the cataract is removed and replaced with a clear lens, called an intraocular lens (IOL). Cataract surgery is a very common and effective procedure that eliminates vision problems caused by cataracts. Approximately four million cataract surgeries are performed in the US each year. Cataract surgery is often recommended when cataracts are causing significant visual difficulties.

What are symptoms of cataracts?

Because cataracts develop slowly, many people do not realize they have them. As cataracts grow, you may notice:

• Cloudy or dim vision
• Colors look faded
• Difficulty seeing well at night
• Sunlight or headlights seem too bright, cause glare, or have a halo around them
• Double vision or multiple images in one eye
• Frequent prescription changes in your eyeglasses

https://www.aao.org/eye-health/diseases/what-are-cataracts

Cataracts can make images appear dull or yellow.

Blurry or dim vision is a symptom of cataracts.

Cataracts can cause distortion or ghost images.

These symptoms can also be caused by other eye problems. The first step in restoring your vision is a medical eye exam with Dr. Bart to learn more.

When should you have cataract surgery?
The decision for cataract surgery is usually based on the degree to which vision is impaired and the impact that impairment has on quality of life. When cataracts limit daily function and enjoyment of everyday tasks and activities, it is time to consider having cataract surgery. The decision for cataract surgery is reached after an exam and discussion between you and Dr. Bart. Dr. Bart explains clearly what is involved in cataract surgery and answer all your questions.

What happens before cataract surgery?

Many precise measurements of your eye will be taken to determine the correct focusing power for your intraocular lens (IOL). You will be asked about any medicines you take. You may be asked not to take some of these medicines before surgery. You will get prescription eye drops to start before surgery. These medicines help decrease inflammation and prevent infection.

What happens during cataract surgery?

The procedure commonly takes place in an outpatient surgery center. Before the procedure, your eye will be numbed with eye drops to prevent pain and you will be given medication to help you relax. During surgery, Dr. Bart removes the cloudy lens and replaces it with a clear artificial lens. The procedure takes only about 15 minutes. The procedure is generally painless. Sometimes there may be a feeling of mild pressure or cool wetness. Typically you are awake during the procedure. You might see light or motion, but you cannot see the procedure. Usually no stitches are placed. Afterward you will rest in the recovery room for 15-30 minutes.

What happens after cataract surgery?

Most daily activities can usually be resumed a day or two after cataract surgery. However, some activities should be avoided for at least the first week, such as lifting heavy things, high-impact activities, bending over, and touching your eye. Vision is typically greatly improved immediately after cataract surgery and continues to sharpen over days to weeks. Most people are pain-free after surgery. Sometimes there is mild scratchiness or soreness for a day or two. Light sensivity may result from the eye not being used to seeing all the light that was previously blocked by the cataract. Patients often notice that colors are brighter and more brilliant. The same prescription drops used before surgery are used after. You will receive a clear, protective eye shield to wear while sleeping. Cataracts cannot regrow after surgery. After cataract surgery, many patients don’t wear glasses nearly as often as before the procedure.

Potential Complications
All types of surgery carry a risk of a complication. Thankfully, cataract surgery by a skilled cataract surgeon is one of the most successful surgeries in all of medicine and has a very low complication rate. On the rare occasion that a complication occurs, it can usually be treated without any long-term consequences.

Intraocular lenses (IOLs)

Tens of millions of intraocular lenses (IOLs) have been implanted. Most IOLs are made of a flexible, foldable material and their diameter is about one-third the diameter of a dime. IOLs do not wear out as do hip and knee implants. Dr. Bart will discuss with you how intraocular lenses (IOLs) work and the many options for IOLs. The type of IOL implanted affects how you see when you are not wearing eyeglasses. Many breakthroughs in IOL design and material enable you to choose what will best suit your visual needs.

Monofocal IOLs have one focusing distance at which vision is sharpest, and glasses are needed to see clearly at other distances. For example, often people choose to have clearest vision at distance in both eyes and use reading glasses for seeing up close.

Other options can decrease your dependence on glasses after surgery.

• With Monovision IOLs, one eye receives a monofocal IOL clearest at distance and the other eye receives a monofocal IOL for near vision. While it may sound surprising, many patients prefer this option to reduce the need for glasses.
• Multifocal IOLs have zones with different powers and can enable vision at distance and near, somewhat similar to bifocal or trifocal eyeglasses.
• Extended depth-of-focus IOLs have one corrective zone that is stretched to allow distance and intermediate vision. Intermediate distance is arm’s length, such as a computer screen or a speedometer in a car.
• Accommodative IOLs can change shape or move inside the eye as the eye's focusing muscle contracts, simulating the eye's natural ability to focus.
• The Light adjustable Lens (LAL) can be customized several weeks after cataract surgery. The focusing power of this monofocal IOL is modified through a series of office-based light treatment procedures. This technology is designed to improve how well you see without eyeglasses.
• Toric IOLs are a type of monofocal IOL that corrects corneal astigmatism. Astigmatism causes blurry vision at all distances. The eye and many of its structures are approximately round, like a baseball. Light comes into the eye and bends evenly, which gives you a clear visual image. But if you have astigmatism, your cornea (the eye’s clear dome) or lens is shaped more like a football or the back of a spoon. Light gets bent more in one direction than another, creating a blurry image. Toric IOLs are available in some but not all of the above IOLs.

Monofocal IOLs are paid for by insurance, including those used with monovision (one IOL set for near and one for far). The other IOLs are not covered by insurance.

What is laser cataract surgery?

Some steps of cataract surgery can be performed by a femtosecond laser instead of manually with a blade or other surgical instrument. The laser instrument uses a range of highly advanced technologies to capture high resolution images of your eyes. (It precisely maps the eye and collects detailed measurements and other data used during the surgery.) These images and the data they provide allow for greater customization in cataract surgery. An advanced computer-guidance system, controlled by Dr. Bart, moves the laser over the eye to create precise results tailored to each individual patient.

What is Optiwave Refractive Analysis (ORA)?

Optiwave Refractive Analysis (ORA) technology uses wavefront technology to provide data on correct IOL power and placement, providing customized treatment and a better visual result.

Glaucoma Treatment During Cataract Surgery
For patients diagnosed with both cataracts and glaucoma, both conditions can be treated during the surgery. Minimally Invasive Glaucoma Surgery (MIGS) can be safely performed at the time of cataract surgery, streamlining care and minimizing recovery time. The purpose of MIGS is to reduce eye pressure, helping to prevent vision loss and optic nerve damage. 

Dr. Bart has state-of-the-art surgical knowledge, skill and experience. For your best vision, schedule a cataract evaluation at the SF Vision Center by phone or request one online today.

TESTIMONIALS

Cataract surgery — The results have been excellent and miraculous. My life has been changed dramatically, I now have 20/20 vision as though my youth has been recaptured. Dr. Bart's surgical skills are unparalleled.


 Elena Y. 

Dr. Bart has operated on both of my eyes. She is board certified in opthalmology and an associate clinical professor at California Pacific Medical Center. She is super! Of all the doctors I've ever consulted, she is the most caring and concientious about following-up and carefully monitoring chronic conditions. She explains procedures and options thoroughly, and her in-depth medical knowledge is always up-to-date. I wouldn't want anyone else taking care of my eye problems. 

Anonymous

Cataract surgery  — It is a miraculous thing to experience 20/20 vision without the use of eye glasses! Because of Dr. Bart I am now unburdened by glasses or contac lenses. She truly is the person to trust for the health of your eyes!

Barbara C.  

The best eye surgeon. I've had lasers done because I'm diabetic. Had two cataract surgery and can see much clearer than before. She's caring, sweet and kind.

Darlene C.

Dr. Bart's office staff is very friendly, professional and helpful with scheduling and reminding me of my appointments, and helping me with any kind of paperwork that I needed. Dr. Bart herself, aside from being so professional, is also very kind and pleasing in her manner, explaining to me every process she performs and answers all my questions and concerns. I was very grateful to her for getting me through my cataract surgery. I'm disappointed in having to discontinue seeing her due to my insurance coverage.

Maria B. 

Dr. Bart is everything one could wish for in a medical professional. She is smart, attentive, and actively interested in the well being of her patients.

Stephen A. 

Stellar knowledge, judgment, experience. Can't imagine wanting to go to anyone else.

David G.