So welcome. You’re gonna get a lot of information today and I’m happy to stay as long as you want me to, to answer your questions or whatever. There’s a lot of misinformation under about Cataracts and Cataract Surgery and we’re gonna try steer you through all those different paths so you’ll know what you need to know.
So basically, Cataract surgery has changed over the last several years. Years ago, you had to go to a hospital, you were sent back for two weeks, couldn’t move, and couldn’t do less. And you ‘wait’ until the Cataract will move up right, which really, that was not the correct term because you really didn’t wait that long. Though I did do a regular Cataract today which we don’t do a lot. And so we’ll go over all that. But today it’s an outpatient surgery for about ten minutes long, the next day he can go play golf and sort of do what he wanted, so it’s totally different than what it used to be.
So, the goals have changed. So now the goal is, and we have a trademark, Precision Cataract Surgery. So now our goal is, is to give you, not just take the Cataract out but to provide you the best possible vision with the least dependency on glasses, if that’s what you choose to do. So we’re not just trying to get the Cataract out, that’s done very well. We’re trying to also maximize the quality of your vision.
So what is a Cataract? I bet everybody here thinks it’s a growth form over their eye. Everybody thinks it’s a film growing over their eye? Not true. I thought everybody thinks so. So that’s one myth that we’re gonna give light to. So your eye works exactly like a camera. If you have a lens, then the lens focuses in its outer film of the camera and that’s how the camera works. So basically, in your human eye, there’s a cornea, which does focusing and then there’s a lens behind your pupil. These two things focus light into the macula, that’s where your clear vision is located, onto your retina. And so an eye and a camera work exactly the same.
So what is a Cataract? So a Cataract is this lens behind your pupil becomes cloudy. It’s not a growth, it’s not growing, it’s not doing anything. It is this is cloudy enough that will be similar to the windshield on your car, it’s fogged enough. It’s not something growing over your windshield. It’s your windshield that’s fogged enough. So the cloudier this lens gets, the more blurred your vision is.
And so what are the symptoms of Cataracts? Bright colors is not really a great symptom that I could tell you about because the Cataracts, in most cases, take years to happen so you really don’t notice there’s any difference in your colors, most likely. You won’t know there’s a difference in the colors ’til after the Cataract surgery and see the difference this time. But it does cause a change in colors.
If he looked at the paintings all day when he was very young, his colors were sort of normal and there was nothing special with his works as a painter, but when the guy, like, to be in his eighties or nineties, when he got to be old, all his paintings became bright and brilliant because he didn’t know he was painting that way. He had Cataracts and he didn’t know that he was painting the way he was painting as far as the colors are concerned.
The things that are common is halos around lights. So very common, for the first symptoms people get with Cataracts is that they have trouble with bright items. They have trouble seeing because things aren’t as bright and they have glare and halos and glare from headlights and lights. Also difficulty in reading in low lights. Same thing, in Cataracts, that lens is not focusing clearly so you need more light to see. So reading can spell trouble in low light obviously the vision can be blurred. Sometimes people see double. And as the Cataracts change, in a lot of people, it makes your eye more nearsighted. So just changing your glasses a lot of times is all that you need to have done with Cataracts. If they’re developing, you don’t have to have surgery. I just gave a talk at Lehi last week and a lady said, ‘I was told I have to have my Cataracts removed’ and that’s not true. And so we’ll go over that.
And so who gets Cataracts? So basically, the clouding of your lens inside your eyes is an aging change. And so, as we age and get older, then we get Cataracts, the lens gets denser and more cloudy as time goes along. And typically this lens takes on a brown and yellowish color. That’s the reason why colors have changed. So you’re almost wearing brown-color sunglasses. It’s not the sunglasses, it’s the lens in your eye.
But I do operate on people who were younger and I have operated on a two-month old. So you can be born with Cataracts but those are very rare and not very common. So basically this is sort of an aging process and what can make this happen or make it worse? So we know that UV light makes Cataracts develop at a faster rate so over years of time, if you’re out on the sun all the time, you wear no sunglasses, no hat or anything, then you’re gonna get Cataracts on an averagely younger age than someone who does.
They did a study, many years ago, on commercial fishermen of Chesapeake Bay and the commercial fisherman who wore no hat or no sunglasses got Cataracts on an averagely younger age than fishermen who wore a hat and/or sunglasses. So it is important to wear sunglasses though if you’re already sixty years old when you start wearing them that’s probably a little too late to start but it still doesn’t hurt.
And so what are the treatments? So what I told you about the lady saying she had to have it done is incorrect. The most common treatment is just watching ’til the Cataract gets worse. Also we can change the glasses and then the last choice is taking the Cataract out. And so I get asked all the time everyday in my office for, ‘When should I do…or what should I do..I’ve been told…or I’ve had second opinions..or..I’ve been told I have to do it’.
And so when should you have Cataract surgery? That’s individual for every person in here, and what their lifestyle is, and what they do. If I got Cataracts and I’m still doing this job, you would want me to have Cataract surgery very early on before I’ll be doing your surgery. So if I’m still doing this and I get Cataracts, I’m not gonna wait very long to get them done. If I’m retired and I can still play tennis or golf or do my computer work or do whatever I’m doing and still doing okay, then I would wait ’til they get worse and then at some point when I have some trouble doing those things, then that’s when I would decide to do it.
Unfortunately, it happens all over the country but really badly here, is that doctors tell people they must do it, have to do it. “If we don’t do it now, the complications will be more later, this is an emergency, some emergency problem and you have to do this now.” The only reason they’re telling people that is because they want a bigger car. That’s not true. If I did your surgery today or I do it a year from now, the results and your success rate is gonna be identical. So it doesn’t matter, medically speaking, when it’s done.
Now we did a lady today that has a ripe or hypermature Cataract. So what is a ripe Cataract? A ripe Cataract is when your pupil turns pure white. So anyone could see that that person had a Cataract. So that no one really, except this lady, she’s ninety years old, she was afraid, that she wouldn’t go to the doctors, and she just let it go until it got that bad. But those are not common. And that is a ripe Cataract. So even thirty years ago no one waited until it got that bad. But it’s just a convenient term that doctors used to say, ‘Well your Cataract is ripe and now we’re gonna do it.” A ripe Cataract is your pupil is white and if you let it go that long, it really at that point, it is more difficult to be preserved, still can be done, still can get right results but it is a little more risky to do it at that point.
So, if all we do is talk about the Cataracts then we’re not gonna correct all your vision. So everyone in their forties gets Presbyopia. So Presbyopia is the inability of your lens to focus from distance to near. So everyone – it happens to everyone’s lens. The lens in your eye loses this ability to focus and it happens to everyone. Now if you’re nearsighted you can take your glasses off and read. But if you’re not nearsighted, then you’re gonna have to have reading glasses or you gonna have to have…if your farsighted, you need to have glasses for distance and reading so you’re in a bifocal.
So then there’s different kinds of lenses. And seven or eight years ago, there’s one kind of lens. Today, we got multiple kinds of lenses. So in our Precision Cataract Surgery Brochure, has a bunch of different options in there on how you choose to correct your vision. So the most common lens, and the first lens was put in an eye in England in 1949. And how that came about was, was eye doctors in England and London were taking care of airmen who were flying with bombing missions over Germany. And they would come back with their planes shut off and the glass or actually Pexiglass would be shattered into their face and they would have these particles that would have penetrated their eye. But once that the eye was so knocked and that part was okay, the little particle in the eye didn’t bother directly, they didn’t get a reaction, their body didn’t tend to reject that material, it was sort of inert. So therefore they decided, well maybe we can make a lens out of that since the eye doesn’t mind it being there, so that’s how the first intraocular lens came about. So since that time, the lenses has gotten better and better and more designs and the size and shape on how they’re made has gotten a lot further along.
Now that lens was one power. So if we put a lens in your eye, and then we do a lot of different measures so that’s part of Precision Cataract Surgery as we just don’t do a little measuring; we do a lot of measuring, a lot of talking about what your options are. And so knowing more about your eye then let’s us pick a better lens for your eye.
A single lens is gonna give you one distance. If you have Astigmatism and you have this plain regular lens, you’re still gonna be blurred because it didn’t correct the Astigmatism. So if you wanna see clearly at distance without glasses, you would have to have the Astigmatism corrected. If you have that, then a plain simple lens will not accomplish that. So we have Astigmatism lenses, we have a regular, these lenses have been around forever. We have sort of a high definition lens. So high definition lens is your cornea is not round, sort of like in the picture, sort of like a basketball. Or if you have Astigmatism, your cornea is shaped like a football.
A regular implant has been around for many, many, many years, because a rounded lens just like your glasses are a rounded lens. We now have your cornea shaped where it’s steeper in the middle and flatter on the periphery so your cornea is aspheric, not spherical. So now we have lenses that have been designed to be aspherical so now the lenses are steeper and more powerful in the middle and less in the periphery, so it more matches your eye so you can get crisper, sharper and more contrast in your vision with that type of lenses. Sort of like going for my regular TV, to a high definition TV. You can still see football on your regular TV, it’s just a little nicer on the flat screen, big screen, high definition TV. So that’s the difference for those kinds of lenses.
And then the last type is called a Restor Lens. So a Restor lens is a lens that has a bifocal lens. You can’t see that on the lens very well but you can see on the picture behind so there’s rings in this lens. So these lenses are called refractive lenses. So a refractive lens splits the image that you’re looking at. So your world has now two images in your eye. There’s an image that is focused for distance and there’s an image that’s focused for near. And so when you look at distance, then the only image that you see clearly in your vision is the distant one. And when you look up close, whether it’s up, down, right or left, different than the bifocal in your glasses, where your eye had to always had to look down, or you look right or left or down, as long as it’s near, then the only image that’s clear in your eye or your vision is the nearer image. So that’s how these lenses give you distance and reading, is these actually give you two images of your retina and it just depends on where you’re looking.
They work really well but they’re not perfect. The disadvantage of this lens is that because of these rings, people do see rings and halos around lights with this type of lens. So out of the seven years or so of having put these lenses in, no one has come back and said, ‘I can’t stand the rings, take the lens out, I don’t like it’, for that reason. Some people are happy for other reasons but not for the ring part. And so even if it’s there it’s not a big problem because now they’re glasses-free so they’re overall still happy and your brain sort of gets used to how you see differently with this lens and those complaints stay away for a few months sometimes. And so the other thing that happens, because you now have two images, is that you need a little more light to read because you now have two images that you’re focusing instead of one. So there is a little bit of contrast as far as that part is. But ninety five percent of people who have this lens see well, do well, and are very happy with how they do with this lens so it does work very well.
So the ability is, is that it gives you distance and reading, as far as your vision goes. So people who have this, like I said, ninety four percent of people never ever put glasses on. There’s some people, because there’s two powers, that maybe in a few people on a computer, is not quite as sharp as they would like it and sometimes they put on a little sheer glass for that distance as far as the Restor Lens goes. And there’s a couple of them for brands. Restor is the one I use most of the time. There’s a lens called Tempest Multifocal. And then there’s another lens that’s called Crystalens. The Crystalens works differently, the Crystalens is still one power but it’s shaped in a way that as your eye try to focus, it moves a little bit inside your eye and changes the strip that way.That’s probably the least used of all the different lenses that do distance and reading because in my hands it was pretty unpredictable, who got some reading and who didn’t in that kind of lens because it didn’t always move the way it was supposed to be.
So what happens on a Cataract surgery then? So basically, you’re gonna go into the surgery center, you don’t need this robe anymore and those kind of things, so you basically go in to the the surgery center. They will start an IV but there’s no bottle attached to an IV, it’s just an IV so they can give you valium-kind of drugs to keep you calm and relaxed and so you’re comfortable to the procedure. You get a whole bunch of dilating drops and numbing drops prior to the surgery so your pupil, ‘cause I said your pupil, the lenses behind your pupil, we’re gonna get your pupil as wide as we can so we can get to the lens. And then we just use numbing drops, there’s no shots, no patches, no stitches.
It’s different in the old days, where you have a patch in your eye, and people got blue-black eyes and bruising because of the injections. I haven’t really done any injections for Cataract routine surgery in probably fifteen years or longer, and so very quickly, when I started sort of a different way to do it, I switched over just because I didn’t like the needle part, and most patients didn’t like it so I didn’t feel comfortable for a long time. So that part, and I’m gonna switch over and have this other computer started out and show you a bunch of stuff about the laser part…