Bringing Incredible Vision to Tarrant County for 28 years
Currently, there is no medical treatment to reverse or prevent the development of cataracts. Once they form, the only one way to achieve clear vision again is to undergo cataract surgery. At Kleiman Evangelista Eye Center, our team of surgeons have performed tens of thousands of successful cataract procedures taking advantage of the advances in cataract techniques as they become available and perfected for their patients.
Cataract surgery has evolved dramatically in recent years, often leading the way for our medical colleagues. Ophthalmologists were the first to utilize microsurgery techniques as the microscope came into use for cataract surgery nearly 20 years ago, and ophthalmologists also pioneered the use of lasers for surgery.
As cataract surgery techniques have improved over the year, the incision required has become smaller and smaller. Roughly 10 years ago, the average cataract incision was nearly 12 millimeters wide. Today, with phacoemulsification, the cataract is removed with a vibrating hand piece, requiring an incision no more than 3 millimeters (⅛ inch) in width.
Flexible lens implants can be folded in half and passed through an incision nearly as small as the phacoemulsification instrument itself. As the incision has shrunken, the need for sutures has diminished to the point where, in the great majority of cataract surgeries, no sutures are required at all.
The advantages of the new, small incision surgery are significant. The eye is more stable because the wound is smaller, which dramatically shortens the customary postoperative restrictions against bending or heavy lifting. Patients are now instructed to limit these activities for only 3-4 days, after which they can resume normal activity.
Another major advantage of the small incision is that it causes much less distortion of the vision. Patients have found that their vision recovers quite well in just a few days.
We typically still wait 3-4 weeks before ordering glasses to ensure that the prescription is as accurate as possible. The number of office visits required following cataract surgery has also decreased, as we now see patients the first day, the first week and one month following cataract surgery.
Another very significant advance in cataract surgery has been the ability to combine small-incision cataract surgery with a glaucoma procedure. This combined operation enables us to solve both problems in certain patients, though it does prolong the visual recovery process and number of necessary postoperative visits.
A final, very exciting advance in cataract surgery is the use of topical anesthesia. In the past, patients were given an injection of anesthetic agent behind the globe to paralyze eye muscles and prevent movement of the eye. The injection was painless and patients tolerated this type of anesthesia very well, however, occasionally a small hemorrhage could develop at the injection site. Another disadvantage was that the eye required a temporary patch following the injection.
Now, with topical anesthesia, doctors administer local anesthetic drops into the eye prior to surgery. The drops provide very adequate anesthesia to the anterior portion of the eyeball and the surgery is performed painlessly. Additionally, the patient can continue to move their eyes and can even help the surgeon by looking in certain directions. The patient does not require a patch following the procedure and can leave the surgeon's office with a regular sunglasses.
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