Sometime after age 50, most of us are likely to hear our eye doctor say, "You have cataracts."
In the early stages of a cataract, vision may be improved with eyeglasses, magnifying lenses, or stronger lighting. When vision loss begins to interfere with daily activities, the cataract will need to be removed through surgery. Cataract removal is the number one therapeutic surgical procedure performed on Americans 65 and older, and is one of the safest and most effective. The operation is generally done on an outpatient basis, and improves vision in more than 90% of patients.
Cataract surgery techniques
Phacoemulsification - This is the most common cataract surgery, in which a tiny probe is inserted through a small incision, emitting ultrasound waves that break up the cloudy center of the lens so it can be removed by suction. In most cataract surgeries, an artificial lens, called an intraocular lens, is implanted into the eye to replace the lens that has been removed. The intraocular lens becomes a permanent part of the eye, improving vision by allowing light to reach the retina and leading to a rapid recovery of sight.
Modern microincision cataract surgery - In this surgery, a round opening is made in the front of the capsule and the cataract is removed through this opening. The back portion of the capsule (known as the posterior capsule) is left in place and used to fixate the intraocular lens in the same location as the natural lens. This membrane is usually initially clear and transparent like saran wrap.
It is not uncommon after cataract surgery for an initially clear posterior capsule to become cloudy months to years after the surgery. It is more likely to develop in young patients and following the removal of certain types of cataracts. Like a healing response, the tendency for the capsule to later cloud varies with the individual. The intraocular lens implant has been shown to decrease frequency of this membrane becoming cloudy and subsequently the need for a YAG laser treatment.
If your posterior capsule becomes cloudy it will cause a progressive reduction in vision and can mimic a lot of the symptoms you had initially with your cataract (blurred vision, halos, etc). When the posterior capsule becomes so cloudy that it is affecting your vision a YAG Laser treatment is usually recommended. In the past, the membrane had to be opened with a knife and there were significant risks since the eye was opened. However, with the advent of the YAG Laser treatment the risks have been significantly reduced.
YAG laser treatment
The microscopic light beam of the YAG laser is focused through the transparent cornea onto the cloudy membrane. The laser then creates an opening in the central aspect of the cloudy membrane. Once the opening is created by the laser, it will remain open and should not need to be repeated. There is no potential for infection or wound complications, and no need for reduced physical activities after the laser procedure. The procedure is performed on an outpatient basis.
Can cataracts be prevented?
We do not yet know how to prevent cataracts, but scientists are examining how they develop and what factors put people at risk for developing them. Regular comprehensive eye exams, especially for people over the age of 60, will allow for early detection of cataracts and other vision problems.