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Surgery Information

Please read below about the exciting new cataract implant options, including the Acrysof Restor multifocal, which is designed to eliminate the need for glasses near and distant after cataract surgery, and the Acrysof IQ Toric, which is designed to eliminate astigmatism after cataract surgery. We are proud to offer these implant options to our patients.

Cataract Surgery

An intraocular lens (IOL) is the artificial lens surgeons implant to replace the eye's crystalline lens that must be removed once it becomes cloudy. The main job of the IOL is to focus light onto the back of the eye (or retina), just as a natural, healthy eye lens would.

From here, the light rays are converted into electrical impulses that travel to the brain, where they are then converted into images. If the light isn't focused correctly on the retina, then the brain can't process the images accurately.

IOLs share the same basic construction as earlier versions—a round, corrective central portion of the lens with 2 arms, or haptics, to keep it in place in the eye—but other than these shared characteristics, modern IOLs can vary widely in ' design, being made of plastic, silicone, or acrylic.

Most of today's IOLs are about a quarter of an inch or less in diameter and soft enough to be folded so they can be placed into the eye through a very small incision.

Types of IOLs

The most common type of IOL is called a posterior chamber lens, meaning it is placed behind the iris within the capsule where the natural lens used to be. When it is placed in front of the iris, as might happen when the lens capsule is damaged, it is called an anterior chamber lens.

Here we focus on the most common type of IOL and the different lenses that have evolved from this technique:

  • Monofocal IOLs, such as the AcrySof® IQ IOL, provide a set focal point, usually for distance vision. This allows cataract surgery patients to see clearly within a range. About 95 percent of people who receive a standard IOL have their vision restored to its pre-cataract state.1 However, most patients still require glasses for reading or distance vision.
  • Monovision is a technique the surgeon may choose to perform that involves inserting an IOL in one eye for near vision and an IOL in the other eye for distance vision. This technique requires adaptation, since each eye will then be oriented towards different needs.

Advanced Technology IOLs

  • Multifocal IOLs, or advanced technology IOLs, are a newer type of lens that treats multiple focal points and reduces or eliminates the need for eyeglasses or contact lenses after cataract surgery. Part of the rapid evolution in IOL innovations, these newer lenses are made from cutting-edge materials with unique features. This is made possible through highly specialized optics that divide light and focus it on more than one point to provide a range from near to far eyesight
  • Accommodative IOLs are considered monofocal, meaning they have a fixed focal point. This type of lens is designed to move in response to your eye's own muscle, which translates into the ability to see multiple focal points

While there are several advanced technology IOLs on the market today, the newer and most popular ones are made by Alcon®, such as the AcrySof® IQ ReSTOR® IOL.

Astigmatism Correcting IOLs

In addition to treating the cataract, some IOLs can also correct astigmatism at the time of surgery. These lenses will minimize the need for distance vision glasses after surgery. One such IOL that has gained widespread popularity is the Alcon® AcrySof® IQ Toric IOL (made specifically to address cataracts with astigmatism).

No single lens works best for everyone. Only your eye doctor can determine the most appropriate option for you and will work with you to help select the right course of treatment.

Glaucoma surgery

In some patients with glaucoma, surgery is recommended. Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.

Laser trabeculoplasty
A surgery called laser trabeculoplasty is often used to treat open-angle glaucoma. There are two types of trabeculoplasty surgery: argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT).

During ALT surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork. The laser does not create new drainage holes, but rather stimulates the drain to function more efficiently.

With SLT, a laser is used at different frequencies, allowing it to work at very low levels. SLT treats specific cells and leaves the mesh-like drainage canals surrounding the iris intact. SLT may be an alternative for those who have been treated unsuccessfully with traditional laser surgery or with pressure-lowering drops.

Even if laser trabeculoplasty is successful, most patients continue taking glaucoma medications after surgery. For many, this surgery is not a permanent solution. Nearly half who receive this surgery develop increased eye pressure again within five years. Many people who have had a successful laser trabeculoplasty have a repeat treatment.

Laser trabeculoplasty can also be used as a first line of treatment for patients who are unwilling or unable to use glaucoma eyedrops.

Laser iridotomy
Laser iridotomy is recommended for treating people with closed-angle glaucoma and those with very narrow drainage angles. A laser creates a small hole about the size of a pinhead through the top part of the iris to improve the flow of aqueous fluid to the drainage angle. This hole is hidden from view by the upper eyelid.

Peripheral iridectomy
When laser iridotomy is unable to stop an acute closed-angle glaucoma attack, or is not possible for other reasons, a peripheral iridectomy may be performed. Performed in an operating room, a small piece of the iris is removed, giving the aqueous fluid access to the drainage angle again. Because most cases of closed-angle glaucoma can be treated with glaucoma medications and laser iridotomy, peripheral iridectomy is rarely necessary.

Trabeculectomy
In trabeculectomy, a small flap is made in the sclera (the outer white coating of your eye). A filtration bleb, or reservoir, is created under the conjunctiva — the thin, filmy membrane that covers the white part of your eye. Once created, the bleb looks like a bump or blister on the white part of the eye above the iris, but the upper eyelid usually covers it. The aqueous humor can now drain through the flap made in the sclera and collect in the bleb, where the fluid will be absorbed into blood vessels around the eye.

Eye pressure is effectively controlled in three out of four people who have trabeculectomy. Although regular follow-up visits with your doctor are still necessary, many patients no longer need to use eyedrops. If the new drainage channel closes or too much fluid begins to drain from the eye, additional surgery may be needed.

 

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