Following cataract surgery, we deliberately leave the back membrane of the lens in place to support the intraocular lens and protect against complications. In over 50% of the eyes, this membrane eventually becomes cloudy. This cloudiness usually develops 1-5 years after surgery. This clouding of the membrane is called a “secondary cataract.” The symptoms of this are often similar to those that occurred with the original cataract. Patients often tell us that their first evidence of a secondary cataract is the constant desire to try to clean their glasses.
If a secondary cataract develops, we can make a small opening in the middle of this membrane using the YAG laser. This can be done quickly and painlessly without requiring an incision in the eye. The membrane almost never grows back after laser treatment. The only exception is in children, in whom the membrane often regrows one or more times. This laser procedure is also what many people confuse with laser cataract surgery.
Will I have an Intraocular Lens Inserted During My Cataract Operation?
Removing the cataract is only the first step in recovering good vision. Since the cataractous lens has now been removed, we must provide an additional lens in order to help the eye focus light clearly. Following cataract surgery, there are three methods by which clear vision can be restored.
Intraocular Lens Implant
Our preferred way to restore vision for nearly all of our patients after cataract removal is to insert an intraocular lens implant into the eye at the time of surgery. This clear implant is placed in the eye behind the iris and pupil in the same position as the natural lens, and it stays in the eye permanently.
Implanting an intraocular lens adds little additional risk for the surgery. Only very rarely does an eye “reject” an implant, and it is even rarer that a lens implant needs to be removed after surgery. Patients who have certain unusual eye conditions might not be good candidates for intraocular lens implantation. We will discuss this with you when planning your surgery.
An intraocular lens is permanantly implanted in the eye after the cataract is removed.
It is possible to implant an intraocular lens in an eye that has had previous cataract surgery. This can be especially beneficial to those who are having difficulty using cataract glasses or contact lenses. Not all patients are good candidates for this surgery. However, secondary lens implantation can be a very rewarding operation for those who have become frustrated with cataract glasses or contact lenses.
Contact Lenses
A contact lens can restore good vision following cataract surgery, and there have been many advances in lens design and materials in recent years. Contact lenses do not cause the visual distortions that occur with cataract glasses. Unfortunately, there are several disadvantages with contact lenses. The major one is that one must learn to insert and remove the contact lens either every night or every few days. In addition, some people are not able to adapt to wearing a contact lens on the eye. Another disadvantage is that a contact lens can be easily damaged or lost, and improper care or use may cause eye infections.
Cataract Glasses
These are thick, heavy glasses that cause a number of significant visual distortions, although the central vision is generally excellent.
Only rarely do we recommend the use of cataract glasses to correct vision after cataract surgery.
Are there Different Types of Intraocular Lenses?
There are countless varieties of intraocular lenses. All lenses contain a clear central portion for focusing the light and some type of flexible arms for supporting the lens inside the eye. The optic of the lens acts just as your natural lens once did, except that it cannot adjust its focus. As a result, you may need to wear regular bifocal glasses following surgery in order to get the best possible vision, especially for reading.
Recent advances in intraocular lens designs and surgical techniques have permitted us to implant lenses through small incisions. These incisions are so small that almost no astigmatism is created and, depending on the particular circumstances, sutures may not even be required to close the incision. Depending upon the condition of your eye, you may or may not be a candidate for one of these types of implants.
Another new type of implant has a bifocal built into it. In some patients, this type of implant may reduce or eliminate the need for reading glasses after cataract surgery. One type of bifocal implant has recently been approved by the FDA. Though it is not recommended for all patients undergoing surgery, it shows great promise for those who meet the carefully defined criteria for receiving this lens.
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