What is a Cataract?
A Cataract is a clouding of the eye’s natural lens, which occurs as we age. The initial result is increasingly blurred vision. If left untreated, cataracts will eventually lead to a complete loss of vision. Currently, the only treatment for cataract is to surgically remove the eye’s natural lens and replace it with a synthetic one (see ReSTOR and Toric lenses) – a clear plastic Intraocular Lens (IOL) made of either PMMA, Acrylic or Silicone. These materials are all biocompatible in the eye and have proven safe for many decades of life.
Cataract surgery is one of the safest and most common surgical procedures performed today. The statistics are impressive. Of the 1.5 million cataract surgeries performed each year, 98% are complication-free and 95% result in improved vision.
Dr. Tinoosh performs no-stitch cataract surgery under topical anesthetic drops. No needles will be used during surgery and patients often require no patch after surgery. More than 98% of patients are pain free, and most see clearly within hours to days after the procedure. There are several types of IOL’s available. Dr. Tinoosh will provide a thorough examination and evaluation to help determine which lens is best for you.
At our Universal Vision Medical Center in Orange County, we use laser-assisted cataract surgery (LACS) as a precise and efficient technique for removing cataracts. LACS uses a femtosecond laser to create incisions and fragment the cataract, reducing surgical time and lowering the risk of complications. The laser’s precision leads to a more predictable and accurate surgical outcome, and it can also correct astigmatism during the procedure, reducing the need for glasses or contacts after surgery. Overall, LACS is a safe and effective procedure with many benefits for our Orange County patients with cataracts.
Cataract Lens & Lens Implants
Intraocular Lens Implants (IOLs) – Cataract Surgery.
Dr. Tinoosh specializes in refractive custom cataract surgery. We try to minimize the refractive error (prescription) as much as possible during cataract surgery, in order to lessen our patients’ dependency on glasses post-operatively. Besides Dr. Tinoosh’s surgical skills, this also requires attention to details during the pre-operative assessment and choice of intraocular lenses. Intraocular lenses are measured using laser interferometry with the Carl Zeiss IOL master. In dense cataracts, immersion A-Scan ultrasonography is also used to confirm the intraocular lens implant measurements. There are many types of IOL’s (Intraocular Lenses) on the market and new ones are being developed every day, including lenses to correct for astigmatism, block UV light and a range of other specific characteristics. Very few insurance carriers cover specialty lenses. Each of these lenses requires specific training and certification for implantation.
There are different types of IOL’s, Monofocal and Multifocal:
Monofocal: This is the traditional IOL, approved by the FDA in 1981. It is a single focus lens that allows for vision at a set distance – near, intermediate or far. Corrective lenses may be needed after cataract surgery with this IOL to compensate for your particular visual needs. When cataracts are present in both eyes, patients may elect to have both eyes implanted with IOL’s that correct for distance. This provides good distance vision, but patients will require reading glasses for up close functions. Patients may elect to have one eye implanted with a near lens and the other with a far lens, a technique called Monovision, which many contact lens wearers are already familiar with. Dr. Tinoosh uses the most advanced monofocal intraocular lenses available, and the wavefront optimized lenses whenever it is possible. These intraocular lenses have the best potential for visual quality and for better night vision.
- Toric Monofocal
- Multifocal or Accommodating
These are the newer IOL’s that allow for greater range of vision and decreased dependency on glasses or contacts. The best part of these accommodating lenses is that they correct for Presbyopia (hardening of the eye’s natural lens as we age). These lenses work in different ways. Depending on your visual needs and characteristics, Dr. Tinoosh will make sure you understand the options and help you make the most informed decision possible. It is important to understand that although these lenses give more ranges of vision, the visual outcome cannot be compared to the natural lens of a perfectly seeing eye at a young age where the eye has perfect ranges of vision. Patients may be spectacle free for most of the time, however, they may still need glasses for some hard visual tasks like night driving or reading, especially in dim illumination or reading very fine print. Here is a very general overview of some of the lenses Dr. Tinoosh prefers.
AcrySof ReSTOR
An Apodized Diffractive lens with multiple zones, which responds to the way light is focused in the eye at various distances – the center is optimized for near vision, with a gradual tapering to the outer edge of the lens that is optimized for distance. The ReSTOR lens provides excellent far away and close-up vision. It provides reasonable intermediate vision (computer distance). It functions almost like glasses with bifocals. AcrySof ReSTOR was approved by the FDA in 2005. Dr. Tinoosh uses the latest generation, the ReSTOR aspheric IOL. This is a wavefront optimized intraocular lens that improves on the previous generation. The ReSTOR IQ currently comes in 2 versions, for maximum optimization of near vision.
TECNIS® multifocal Lens
The advanced TECNIS® Multifocal is an implantable lens that significantly improves vision after cataract surgery and corrects presbyopia. Designed to help you regain younger vision and be free of glasses, the TECNIS® Multifocal Lens can provide you with high-quality vision at all distances and in all lighting conditions—even in dim light. If you enjoy activities such as reading, boating, quilting, playing golf, sightseeing, or surfing the Internet, the TECNIS® Multifocal Lens allows you to lead an active lifestyle. (Only with the TECNIS® Multifocal IOL: • High-quality vision even in low-light environments, such as reading a menu in a dim restaurant or driving at night. • Excellent vision for all distances—near, far, and everything in between. • Nearly 9 out of 10 patients never have to wear glasses.)
Crystalens
Crystalens is a revolutionary new breakthrough in vision enhancement. It is the first intraocular lens (IOL) replacement for cataracts that focuses like the eye’s natural lens, allowing for continuous vision up close, far away and all distances in between.
By using the eye’s muscle to move the lens backwards and forwards naturally in response to the brain’s desire to see at different distances. Crystalens enables the eye to focus continuously and seamlessly through a range of distances, including near, far and everything in between. Patients experience the same vision they had when they were younger, for most without the inconvenience of corrective lenses. The Crystalens is ideally suited for men and women aged 50 to 64 years of age with cataracts who want to not only restore clarity in their vision, but restore their near, intermediate, and distance vision.
Symfony Lens
When cataract is removed, a lens is placed inside of the eye. It is a great eye surgery, because patients who had been nearsighted or farsighted can now be made to have excellent vision without glasses.
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Symfony Getting Started
Symfony Lens delivers a continuous full range of high quality vision with reduced incidence of halos and glare comparable to a multifocal IOL. The Symfony lens, which treats presbyopia (age-related long-sightedness) is implanted into the eye during a normal cataract operation.
LEAVE A LEGACY OF SEAMLESS BRILLIANCE
Look forward to better vision with personalized options for +3.25 your lifestyle. TECNIS Multifocal Low Add Patient Education Brochure
Accommodating IOL (Crystalens)
Crystalens AO Lens is an artificial lens implant that can treat both a person’s cataracts and presbyopia —the clouding or hardening of your lenses, and the loss of near and intermediate vision, respectively. Crystalens was modeled after the human eye. Like the natural lens, it is a lens implant that uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens dynamically adjusts to your visual needs. Many patients will have greater freedom from glasses after surgery, but you may still need reading glasses for small print or other near vision tasks.
Crystalens AO is implanted during one of the most commonly performed surgeries in the world. Over 3 million cataract surgeries are performed in the US every year.
Key Features & Benefits
The first FDA-approved accommodating intraocular lens – meaning that it uses the natural focusing ability of the eyeCrystalens AO was inspired by the eye’s natural crystalline lens.Unlike multifocal lenses, Crystalens AO directs all available light received by the eye to a single focal point, so that you can focus on objects at all distances.
An Important Choice
During cataract surgery, your physician will replace your natural lens with an IOL. Today there are multiple types of IOLs, each delivering a different performance profile based on how the lens is designed. Ask your doctor about standard monofocal IOLs, multifocal IOLs, and Crystalens accommodating IOLs to see which is right for you.Standard monofocal IOLs deliver improved vision at just one distance, usually far. Multifocal IOLs are designed to deliver improved vision for distance and near. However, some patients may experience some halos and glare when driving at night, and some patients have difficulty adjusting to their new vision.
Crystalens IOLs are designed to reduce your need for prescription glasses during your normal daily activities. Crystalens has flexible hinges that enable it to move and flex with your eye, in response to the eye’s focusing muscle. Its movement is similar to the eye’s natural lens.
Alcon AcrySof® IQ Vivity™ Extended Vision Family of IOLs
The AcrySof® IQ Vivity™ Extended Vision IOL is a type of IOL used to focus images clearly onto the back of your eye (retina) to allow clear vision after the cataract removal. The AcrySof® IQ Vivity™ Extended Vision IOL provides clear distance vision (e.g., for watching children playing in the backyard). In addition, the AcrySof® IQ Vivity™ Extended Vision IOL allows for better intermediate (working on a computer, applying makeup or shaving) and some near (reading, knitting) vision compared to what a monofocal IOL would provide. The AcrySof® IQ Vivity™ IOL is not a multifocal IOL, as it uses a new Wavefront-Shaping technology to provide the broader range of vision. There is a chance you may still need glasses for distance, intermediate, and/or near vision. You will get the full benefit of the AcrySof® IQ Vivity™ Extended Vision IOL when it is implanted in both eyes. Please discuss with your eye doctor whether this is the right IOL for you.
Johnson & Johnson Vision Introduces TECNIS Synergy™ IOL
- TECNIS Synergy™ IOL delivers continuous high-contrast vision for patients with cataracts from far through near, even in low-light conditions1,2
- Clinical data being presented demonstrates TECNIS Synergy™ IOL gives broad range of continuous vision and offers patients the freedom to focus within the range
- TECNIS Synergy™ IOL is the latest and most advanced lens within the industry-leading portfolio of TECNIS® presbyopia-correcting intraocular lenses
Alcon PanOptix® Lens
The PanOptix® Lens enhances quality as well as range, so your vision will be as sharp and vivid as it is complete.
- See Effortlessly No blurry zones means you can see without straining to focus.
- Discover High-Definition The PanOptix® Lens delivers all around brighter, more vivid colors.
- Sharpen Up The PanOptix® Lens corrects and sharpens your vision, so you’re likely to wear glasses less often.
- Stay in the Clear Patients reported that they were less bothered by glare around bright lights.
Monovision
Monovision addresses the problem of presbyopia that most people start to encounter at the age of 40-45 when they begin to need reading glasses or bifocals for close vision. With monovision, the dominant eye (the eye you would use to focus a camera) is focused for distance vision, and the non-dominant eye is focused for near to intermediate vision. This can be done with contact lenses, refractive surgery, or intraocular lenses. Monovision certainly isn’t appropriate for everyone. However, when paired with the right person, it can be a great fit. Monovision is a blend of near and distance vision, and is ideal for people with an active lifestyle. However, there is a caveat to consider: since it is a compromise, most people’s vision is not perfectly crisp up close or far away. Instead, it offers the best of both worlds.