Cataract Surgery

Your eye has a clear lens through which light passes, allowing you to see. When the lens loses its transparency, the cloudy tissue that develops is known as a cataract. Cataracts are the leading cause of vision loss among adults. Now, the 650,000 Southern Californians who suffer from cataracts have access to the first significant treatment advance in more than a decade.

A cataract is a progressive clouding of the eye's natural lens that interferes with light passing through to the retina. Sufferers usually describe the condition as being similar to looking through a waterfall, or a piece of wax paper, with a gradual blurring or dimming of vision.

• Blurred/hazy vision
• Spots in front of the eye(s)
• Sensitivity to glare
• A feeling of “film” over the eye(s)

Most people develop cataracts simply as a result of aging, with the majority of cases occurring in people over the age of 55. Over 1.2 million Americans are diagnosed with cataracts each year. Other risk factors include eye injury or disease, a family history of cataracts, smoking or use of certain medications.

For people who are significantly affected by cataracts, lens replacement surgery may be recommended. During cataract replacement, the most common surgical procedure in the country, the lens is removed and replaced with an artificial one called an intraocular lens (IOL).

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Normal Eye The clear lens focuses light on the retina.

Cataract Eye The cataract interferes with light before it reaches the retina.

After Surgery An IOL replaces the eye's natural lens after cataract removal.

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Cataract Surgery

Routine

Cataract surgery removes the cloudy lens and replaces it with a clear artificial lens called an intraocular lens (IOL).

We perform a minimally invasive, small-incision, no-stitch cataract surgery called phacoemulsification ("phaco") surgery. First, the eye is numbed with anesthesia. Then a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces. The pieces are then suctioned out through the probe.

After the cloudy lens has been removed, a new artificial lens, or IOL, is implanted in the eye. With the recent advance of foldable IOLs, artificial lenses can be implanted through the same small incision from the phaco procedure.

Cataract surgery involves the use of micro-incisions to remove the clouded lens and replace it with a man-made artificial lens. Mathematical, computer driven formulas are used to select the power for the new lens. The traditional artificial lens does not allow the eye to focus at varied distances. The traditional artificial lens is single focus, or monofocal, which means that it can provide clear vision for distance or near, but not both.

Typically, we target the traditional artificial lens for distance correction. Ideally, the artificial lens provides clear vision for distance without eyeglasses. In this scenario, you would be less spectacle dependent and need glasses only for near work after cataract surgery.

Additionally, astigmatism, a very common irregular curvature of the eye, may require the use of eyeglasses for distance and near following surgery.

 

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Complex

Dr. Samuel Masket’s areas of special interest and expertise include multifocal and astigmatism correcting intraocular lenses and artificial iris replacement devices for eyes that have sustained prior injury.

A case study can be seen below.

The picture on the left shows the result of an injury to the right eye of a 50 year old woman. The iris was damaged and was separated from its internal attachment and a cataract developed. At surgery Dr. Masket repaired the disinserted iris, removed the cataract and placed the artificial black iris diaphragm to prevent the patient from having glare and light sensitivity. She was markedly improved following her surgery.

 

FLOMAX and Cataract Surgery

You may have noted television advertisements that alert patients about cataract surgery when using a drug known as Flomax. In recent years pharmaceutical agents have been prescribed to help patients, mostly men, with prostate related difficulties in passing urine. Flomax (generic) is most commonly used and has been associated with a new condition during cataract surgery, the floppy iris syndrome. Initially this condition caused a greater chance for complications during cataract surgery.

However, Dr. Masket was part of a national study of the condition and developed a method to prevent surgical problems so long as the patient informed him of use of Flomax. Dr Masket recommends that all patients considering the use of Flomax follow these guidelines:

1. Have an eye examination to determine if cataracts are present
2. If cataract formation is found, consider surgery before starting Flomax
3. If Flomax is already being used, continue routinely but inform the office of its use
4. Inform the office if you have previously used Flomax but have presently stopped its use
5. Do not be especially concerned if cataract surgery is needed, as Dr. Masket had developed methods that prevent chances for complications

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