Latest Technology For Eye Surgery

Part of the problem lies in the term itself. "Cataracts" sounds like the name of a "thing," not a condition, which it is. When a cataract is removed, it is actually the interior substance of the lens which is taken out. Dr. Geves S. Kenny, associate clinical professor of ophthalmology at UC San Diego and medical director of the San Diego Eye Bank, said many patients seem to think that a cataract is a film covering the surface of the eye. Instead, Kenny said, it is the clouding of the proteins inside the lens which causes the eyesight to become blurred.

Surgeons have been able to remove cataracts for years, Kenny added, but the means for restoring sight were so unsatisfactory that poor vision was often preferable. "Cataract glasses and contact lenses were the only alternatives for focusing following surgery," said Kenny.

Now, however, new techniques usually can not only return the eyesight to what it was before the cataract formed, but, if there is an astigmatism, can often make the eyesight better than it ever has been.

Some surgeons, like Massengill, now take the time to reshape the eye following the removal of the cataract by changing the curvature of the cornea. Lens implants, which are permanently implanted in the eye, have, in nearly all cases, according to Kenny, become the best option for restoring clear vision.

He said that lenses with ultraviolet filters-necessary for the protection of the retina-are also an important new advance. Otherwise, he said, patients need to wear sunglasses with ultraviolet filters any time their eyes are exposed to sunlight or even strong fluorescent lighting.

Kenny said that a common misconception about cataracts has to do with laser surgery. A laser can be used in cataract surgery, he said, but only to open the capsule of the lens, not to perform the cataract surgery itself. The procedure that was performed on Hart's eyes is "tiny-incision" cataract surgery, using ultrasound. Called phacoemulsification, an ultrasonic probe is inserted into the lens capsule and vibrated at a high frequency to emulsify the clouded lens material which is simultaneously suctioned from the capsule. The advantages of this type of surgery is that a small incision allows most patients to resume normal activities almost immediately.

Being able to see again-to be independent-seemed like a miracle to Hart, but cataract surgery may still not be for everyone, Kenny said.

If a patient has severe retinal problems, for example, he said, even though the cataract can be removed, there may be no appreciable improvement of the patient's sight. Kenny believes that retina testing with newly developed, sophisticated instruments can be a big help in determining the prognosis for cataract surgery.