Custom Cataract Removal Surgery to Address Your Needs

[00:00:09.560] First, what is a cataract? [00:00:11.880] A cataract isn't a growth over the eyes as some people think that it is, [00:00:16.920] a cataract simply means that our lens, the lens being situated behind the pupil, [00:00:23.720] our lens, through natural aging, starts becoming clouded. [00:00:28.200] That process can actually start typically in the age of 60s and beyond, [00:00:34.120] and of course, as we get older, [00:00:36.040] the lens is likely to become more clouded. [00:00:39.600] There certainly can be other factors that can contribute to clouding [00:00:43.320] of the lens at an earlier age. [00:00:45.880] The most common, of course, being diabetic patients [00:00:49.640] and those individuals who take steroid medication. [00:00:53.520] But in general terms, let's keep it simple. [00:00:56.360] Let's talk about age-related cataracts. [00:00:59.720] In a cataract procedure, what we are doing is, [00:01:03.600] we're essentially removing that clouded lens from behind the pupil, [00:01:07.880] and then we're replacing it with a synthetic lens [00:01:11.080] called an Intraocular Lens Implant, also known as an IOL. [00:01:16.640] In modern day cataract surgery, everyone gets some type of lens implant, [00:01:22.000] because without a lens implant, it would take very, very thick [00:01:26.520] coke-bottle glasses to correct the vision. [00:01:30.040] Some of you may not be old enough to remember in the old days [00:01:33.760] when patients would have to wear very, very thick coke-bottle glasses [00:01:38.560] that had all sorts of side effects after cataract surgery. [00:01:42.680] Now with the advent of Intraocular Lens Implants, [00:01:46.960] cataract surgery has been revolutionized. [00:01:49.680] One of the things I'm very proud of in our practice [00:01:53.000] is that since day one, [00:01:54.520] we've made an investment [00:01:56.480] in the most advanced state-of-the-art technology, [00:02:00.240] which we'll talk about in a moment. [00:02:01.760] In cataract surgery, [00:02:03.520] the surgical procedure is performed one eye at a time, [00:02:08.400] unlike eyelid surgery where both eyelids are performed simultaneously. [00:02:13.720] On the day of the surgery, it is imperative [00:02:16.800] that someone drive you home. [00:02:18.520] The reason for that is that you will be given [00:02:21.200] some intravenous sedation for comfort. [00:02:25.320] It is not possible to drive yourself home, sorry. [00:02:29.840] Postoperatively, [00:02:30.640] the patient will be using some eyedrops [00:02:33.080] to help the healing process, prevent infection, [00:02:36.680] and allow the vision to clear. [00:02:39.760] It is very rare that I place physical restrictions [00:02:43.760] after cataract surgery insofar as bending, lifting, or exercise. [00:02:49.880] Now let's talk about some of the advanced technologies [00:02:53.160] that I commonly use during cataract surgery. [00:02:57.200] It is standard nowadays in modern day surgery [00:03:00.640] that the clouded lens or the cataract is removed via ultrasound [00:03:06.360] or what is known as phacoemulsification. [00:03:10.600] But prior to doing the ultrasound, many patients choose [00:03:15.040] to have what is known as the LenSx Femtosecond Laser. [00:03:19.920] This is a unique type of laser which helps in many different ways. [00:03:24.880] It makes a very clean and accurate surgical incision in the cornea. [00:03:30.440] It makes the opening in the cataract, called a capsule orexis, [00:03:35.640] and it also breaks up the cataract, making the ultrasound [00:03:40.240] or phacoemulsification smoother and a bit easier. [00:03:45.280] With this type of technology, there are certain parts of the procedure [00:03:49.960] that can be quite automated and quite precise [00:03:53.920] and aren't subject to the human hand. [00:03:56.840] However, contrary to what some patients might believe, [00:04:00.960] using the laser [00:04:02.520] does not mean that there are not manual components to the surgery. [00:04:06.480] There still are components where surgical dextarity [00:04:10.720] and surgical skill are necessary. [00:04:12.920] After the cataract has been removed, [00:04:15.600] one is going to insert some type of Intraocular Lens Implant. [00:04:19.880] Before doing so, [00:04:21.720] I like using ORA technology, O-R-A. [00:04:25.680] The ORA is a laser-guided measurement performed on the table, [00:04:30.040] which just takes a number of seconds [00:04:32.800] to calculate the appropriate lens implant power [00:04:37.000] to try to meet our post-operative goal [00:04:40.760] or target for the prescription of the eye for what's known as the refraction. [00:04:46.800] There are preoperative measurements that are done before surgery [00:04:50.000] which are very good. [00:04:51.960] However, the ORA technology takes it to a much higher level [00:04:56.160] with higher resolution [00:04:58.120] to have an increased statistical likelihood [00:05:01.800] of hitting our target. [00:05:03.960] I'm a firm believer in the ORA technology which we've offered for over a decade, [00:05:09.040] and I've seen outstanding results with it, [00:05:12.320] and I certainly recommend it to our patients. [00:05:16.200] In terms of selecting a lens implant, [00:05:18.880] one of the things that I will be talking to you [00:05:21.760] during your consultation [00:05:23.520] is some of the options that may exist. [00:05:27.640] Not all of these options exist for each patient [00:05:31.160] because one has to customize and individualize [00:05:34.640] based upon specific parameters of your eye, [00:05:38.160] based upon what other comorbid conditions. [00:05:42.000] What I mean by that is, do you have any other conditions [00:05:45.880] that could affect the outcome of the surgery? [00:05:48.320] Do you have pre-existing macular degeneration? [00:05:51.720] Do you have pre-existing glaucoma? Are there other pathologies of the retina? [00:05:57.320] These all play a role in selecting the proper type of lens implant. [00:06:01.880] The Basic or Standard Lens Implant [00:06:04.680] is what we refer to as a Fixed-Focus Implant. [00:06:08.440] That's an implant to get your best vision without glasses, either at distance, [00:06:15.320] which is what most people select, [00:06:17.360] but a few do select at near, to be near sighted, [00:06:20.880] meaning to be able to read up close without glasses. [00:06:24.920] But with a Fixed-Focus Implant, [00:06:27.360] definitely one is going to need glasses for at least one thing or the other. [00:06:32.600] If the implant is focused at distance, then you're going to need reading glasses. [00:06:37.040] If the implant is focused at near, then you're going to need driving glasses. [00:06:41.560] That's the Standard or Basic Implant. [00:06:44.320] However, over the last decade or two, there has been an advent [00:06:49.000] of what are called Advanced Technology Implants, [00:06:53.000] formerly known as Premium Implants, [00:06:55.480] but really the technology is outstanding. [00:06:58.160] One of the more common ones [00:06:59.560] that I've used since it was FDA approved in 1999 [00:07:05.720] is the Toric Intraocular Lens implant. [00:07:09.120] What is a Toric Implant? [00:07:11.440] You may have heard the term astigmatism. [00:07:14.240] Astigmatism is not a medical condition. [00:07:16.920] Astigmatism is a function of the curvature of the front of the eye, the cornea, [00:07:22.040] not being spherical like a basketball. [00:07:25.800] If we use the exaggerated example of a football, [00:07:30.040] a football when you look at it from the nose, [00:07:32.400] is quite pointy. [00:07:33.360] When you look at it from the side, it's quite flat. [00:07:36.600] That difference in curvature [00:07:38.760] for an eyeball would be known as astigmatism. [00:07:42.280] With a Toric Lens Implant, what makes it unique [00:07:45.760] is that it has an astigmatism correction built into the implant, [00:07:50.280] which helps the vision tremendously postoperatively. [00:07:53.920] Some patients may ask, "So what? I have astigmatism. [00:07:57.880] Why bother with a Toric Implant?" [00:08:00.960] If we address the vision not only by removing the cataract, [00:08:04.760] but also by reducing or eliminating the astigmatism, [00:08:09.200] one can make the vision after surgery [00:08:11.960] even better in terms of quality and clarity. [00:08:15.160] Why not? [00:08:16.840] In our practice, 30% of all of my cataract surgeries [00:08:21.520] receive some toric lens implant because astigmatism is quite common. [00:08:28.000] What other types of advanced technology implants are there? [00:08:31.920] There are multifocal or extended depth of focus implants. [00:08:36.560] These are implants that can focus distance and near [00:08:40.280] or distance and intermediate, [00:08:42.520] and they can significantly reduce the need for glasses overall. [00:08:48.400] Of course, one can never guarantee for each and every patient [00:08:52.360] that he or she will never, ever need to use glasses again. [00:08:56.640] But if the goal is independence from glasses, [00:09:00.120] there are many options available that can really provide [00:09:03.720] a significant degree of independence from glasses [00:09:07.320] and in many cases, eliminate them altogether. [00:09:10.760] Again, during my examination and my consultation with you, [00:09:15.400] we will discuss these options, [00:09:16.920] and I will be very clear and honest with you [00:09:18.320] in terms of what options may be suitable for you, [00:09:22.840] and perhaps which options may not be suitable for you. [00:09:26.280] It's very important that we have the same goal, [00:09:29.720] and my job is to do my very, very best to satisfy your needs, goals, [00:09:35.280] and expectations, [00:09:37.280] but at the same time, keeping reality in mind. [00:09:41.400] Because although refractive cataract surgery [00:09:44.280] is very advanced [00:09:46.280] in the 21st century, [00:09:48.400] as with any surgery, nothing is perfect 100% of the time, [00:09:53.000] even though I try to achieve that level. [00:09:58.040] Thank you for listening. [00:09:59.640] I hope this has been informative and I look forward to seeing you soon.