How To Regain Eyesight

After-Cataract (Secondary Cataract)
 
When the clouded natural lens is removed and a synthetic lens implanted, it's impossible for cataracts to "come back." Sometimes, however, the natural lens capsule, part of which remains in the eye to hold the implanted lens in place, becomes clouded or thickened. This posterior capsule opacity - which can develop months or years after your surgery - is also called an after-cataract or secondary cataract. It is quite common and affects younger patients more often than older patients. 
 

How To Regain Eyesight

Fortunately, the problem can be quickly and safely repaired with a five-minute outpatient procedure called YAG laser capsulotomy. Your eye surgeon will use an yttrium aluminum garnet (FAG) laser to make a small hole in the back of the lens capsule, allowing light through. The procedure is painless, requiring no incision or sutures.
 
When to Call Your Doctor 

Get in touch with your doctor right away or follow his or her emergency instructions if you are concerned about symptoms that are more severe or last longer than expected. These may include inflammation (pain, redness, swelling), haziness, marked decrease in vision, nausea, vomiting, excessive coughing, light flashes, or multiple floaters. 

The Future of Cataract Treatment 

As baby boomers approach their mid-sixties, the volume of cataract surgery is skyrocketing, as is the demand for even greater safety, convenience, and visual acuity. Accordingly, researchers throughout the world are investigating, testing, or introducing lens materials, surgical techniques, and prevention methods that could revolutionize the treatment of not only cataracts but also other eye conditions, such as glaucoma, macular degeneration, and presbyopia. Here is just a sample of cataract-related scientific work in various stages of development:
 
Cataract Prevention Strategies

• Formulation of chemical compounds to prevent or halt cataract development, which might also stop the progression of muscular dystrophy, traumatic brain injury, and Type 2 diabetes
• The use of topical antioxidants to remove heavy metal ions from the eye, with promising results, especially in the treatment of diabetic cataracts
• Genetic research that could lead to gene therapy for cataracts and other eye disorders 

Prevention of After-Cataracts (Posterior Capsule Opacification)

• Improvements in IOL design and materials, such as development of a polyethylene glycol coating that would prevent formation of opacities on the capsule
• Refinements in phacoemulsification techniques

Intraocular Lens (IOL) Improvements

• Development of an implantable lens gel 
• Development of IOLs whose focusing strength can be adjusted after cataract surgery by applying the appropriate wavelength of light to change the lens's shape

Also Being Studied

• Development of IOL injection devices, combined with new ultrasonic probes, for use in incisions as small as one millimeter
• Refinements in IOL power calculation
• Prevention of infection and inflammation by implanting a drug-delivery device in the eye 
• A two-stage cataract procedure, consisting of standard cataract surgery followed by refractive surgery using a special laser to precisely adjust the shape of the cornea 
• Presbyopic corneal inlays, for improved near vision while retaining distance vision 

Ophthalmic researchers and optical scientists envision exciting possibilities for safe, noninvasive ways to prevent and correct vision damage in people of all ages. Some of the developments described above are many years away from practical application. Others are just becoming available for use by experienced and highly skilled eye surgeons.
 

One thing is certain: Cataract surgery and lens replacement have made huge strides in just the past few years. The procedure is safer and faster, and the results more satisfying, than anyone could have imagined in the days when, after cataract surgery, patients had to wear thick, heavy eyeglasses to have any vision at all. If you have cataract surgery today, and your surgeon has kept abreast of improved techniques and materials, you can thank the pioneering work of scientists and eye specialists for restored clarity of vision, independence, and quality of life that you will appreciate as never before. To find out more, you can check out How To Regain Eyesight.

Removal Of Cataract

Normal Side Effects 

For a few days after your cataract surgery you might experience a slight aching or tenderness of the eye. Only about 5 percent of patients are uncomfortable enough to take an over-the-counter pain reliever. Also normal and to be expected are itching, scratchiness, watering or dryness, and sensitivity to light.

As mentioned, you'll notice fluctuations in your vision for a few weeks or even longer, depending on the lens implanted and your own healing process. These changes should not be severe enough to interfere with your day-to-day activities.
 

Removal Of Cataract

Potential Complications During Surgery 

In the clear-corneal phacoemulsification procedure, the incision is minuscule and no needles are used, making complications during surgery relatively rare. Complications such as rupture of the capsule, perforation of the eye, bleeding from the choroid, and damage to a nerve were much more common in past years, when cataract surgery was more invasive.

Retained Cataract Fragments
 
Very rarely, fragments of the cataract fall into the vitreous cavity, the space between the lens and the retina, and may have to be removed surgically to prevent inflammation.
 
Potential Complications After Surgery 

Complications from cataract surgery occur in only a tiny percentage of patients. The risks are almost nil in the hands of an excellent surgeon. When rare complications do occur, however, a few can be serious and might require immediate medical attention.
 
Be sure to ask your doctor what you should do - both during and after office hours - if you have symptoms of potentially serious complications.
 
Infection 

Fewer than one-tenth of 1 percent (0.1%) of cataract-surgery patients get endophthalmitis, a bacterial (or occasionally fungal) infection of the inner eye. Symptoms can include pain, loss of vision, and excessive redness. If not treated immediately, the condition might damage the vision. The usual treatment is injection of antibiotics into the eye. Rarely, vitrectomy - removal of the vitreous - is necessary to control the infection.

Retinal Detachment
 
In about one-half of 1 percent (0.5%) of patients, vitreous fluid seeps through a tear in the retina after cataract surgery, separating the retina from the back of the eye. Extremely nearsighted patients are at greater-than-normal risk for retinal detachment.
 
Symptoms include a shower of new floaters, much like a swarm of bees, in the vision, or extensive flashes of light, akin to fireworks. The most distinctive symptom is complete or partial loss of vision in the affected eye. Patients report feeling as if a curtain is moving across their field of vision.
 
Like infection, retinal detachment is a medical emergency. If you have symptoms of either, you should seek treatment immediately, day or night.
 
Inflammation
 
Slight inflammation within the eye is normal for a day or two after surgery. Very unusual is prolonged inflammation of eye membranes (uveitis) or the macula (cystoid macular edema, caused by accumulation of fluid in the retina). These can usually be managed using anti-inflammatory eye drops. Corneal edema, an inflammation of the cornea, may in extreme cases require a cornea transplant. Report any eye pain, tenderness, or swelling in your ophthalmologist immediately. 

Lens Shifting
 
Rarely, the implanted lens shifts or rotates within the eye. It can be replaced surgically, although wearing thin eyeglasses usually solves the problem.
 

Incorrect Prescription
 
A capable, experienced eye surgeon will carefully formulate the prescription for your lens using measurements of the cornea and the length of the eye. This formulation is more difficult if you are extremely farsighted or nearsighted or if you've had LASIK or another type of refractive surgery - all of which underscores the importance of finding the best ophthalmologist available, ideally one who specializes in cataract surgery. If it turns out that the lens is too strong or too weak, the solution is to perform additional surgery to improve the focusing or rarely to replace it surgically. To find out more, you can check out Removal Of Cataract.
 

Eye Surgery Cataract

Vision Immediately after Surgery 

Don't be surprised if your vision fluctuates for several days as the eye heals and the pupil returns to its normal size. Your eyesight might seem to be getting worse, then better, off and on for a few weeks. As mentioned, you'll notice fluctuations in your vision for a few weeks or even longer if you have had an accommodating lens implanted. This is normal and expected.

Eye Surgery Cataract

Inside the eye there will be swelling and inflammation. These symptoms should subside within a week, but each patient is different. Younger patients, in theft fifties or sixties, and those with milder cataracts, heal more quickly than patients who are older or whose cataracts were extensive. Be assured, however, that the amount of time it takes your eye to heal won't change the ultimate outcome.

You'll see everything more clearly - including any preexisting floaters, those little objects in the vitreous humor that float across your field of vision. So if occasionally you notice something that looks like a gnat hovering at the edge of your field of vision, it's nothing to be concerned about.
 
Results of Cataract Surgery
 
After your eyes have healed and your brain and muscles have adjusted to the implanted lenses, your world will be brighter and clearer. You'll be able to focus better. Objects won't appear distorted-ghosting and double vision, though possibly not eliminated completely, will no longer be a problem. Colors will appear richer and more distinct. Contrast will be sharper.
 
You'll see well enough to work, to move around independently, and to enjoy the activities that you might have put on hold. You'll be less dependent on eyeglasses - you might not need them at all. Ideally, you'll be able to read the newspaper in good light. You probably won't be able to read the tiny print on products such as sweetener packets without a magnifying glass, but that's okay. Cataract surgery isn't a fountain of youth, but it does improve your vision. Being in your sixties, seventies, eighties, or nineties, and having the vision of a forty-year-old, is an amazing thing in itself.
 
As mentioned, your vision will fluctuate for a few weeks or longer, depending on the type of lens implanted. Even so, within twenty-four hours your eyesight will be markedly improved - so much so that you'll probably be eager to schedule surgery for the other eye at your follow-up visit to your doctor. Cataract surgery is a low-risk procedure, and complications are rare. Still, you should be aware of possible side effects and potential problems.

Risks and Side Effects of Cataract Surgery 

The success of surgery is greatly dependent on the skill and experience of your surgeon. It's important that you make a careful, informed choice regarding your surgeon and that you follow his or her instructions for aftercare, including follow-up visits.

No replacement lens, however sophisticated it might be, is as good as a young, healthy, crystal clear natural lens. Though your vision will almost certainly be better than before your surgery, it will not be as sharp as a teenager's. Nighttime halos and glare, double vision, and ghosting might not be eliminated altogether.

Even so, by replacing a clouded natural lens - which is only going to get worse over time - with a clear, durable, state-of-the-art synthetic lens, you will see images more vividly than you have for years (including those occasional dots in your field of vision - tiny fragments known as floaters). You'll enjoy greater independence and a wider range of activities. And all this will be possible with less dependence - maybe even no dependence - on eyeglasses. To find out more, you can check out Eye Surgery Cataract.