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Go from cloudy to clear with cataract surgery: new techniques can restore vision lost to cataracts and may reduce your need for glasses.

When vision problems from cataracts affect your day-today activities, it's time to consider surgery, a Cleveland Clinic expert says.

New advances have made cataract surgery one of the most successful operations, and afforded patients a chance not only to improve the visual acuity lost to cataracts, but also to correct other vision problems.

"Cataract surgery has a high rate of success in restoring good vision," says Michael Millstein, MD, with Cleveland Clinic's Cole Eye Institute. "There are so many good options these days that people can have implants and cataract techniques that can reduce their need for glasses."


Cataracts occur when the clear, flexible lens in your eye thickens and clouds. As a result, light that passes through the lens and is normally focused precisely on the retina becomes scattered, reducing vision.

Cataracts may cause blurred vision, sensitivity to light or glare, poor night vision, loss of contrast, and double vision in one eye.

In standard cataract surgery, the surgeon makes a tiny incision in the front of the eye, uses an ultrasound probe to remove the clouded lens, and replaces it with a clear intraocular lens implant. New lenses correct not only cataracts, but also problems with distance vision and near vision.

Today, some surgeons use lasers to remove the cataract, aided by three-dimensional imaging to make more precise incisions and improve healing of the eye. The treatment also can correct astigmatism, an irregularly shaped cornea, and potentially reduce your reliance on eyeglasses.

"Laser-assisted cataract surgery can improve the quality of a patient's vision beyond what they could have had with standard cataract surgery," Dr. Millstein says. "The laser can reduce astigmatism and give you better quality of vision than might have been possible a few years ago." However, although Medicare and most other insurance providers pay for cataract surgery, most won't cover the added expense of the laser procedure, Dr. Millstein says. Standard cataract surgery is safe and effective, so you can achieve a good outcome with this approach if you don't want to spend the extra money.


An evaluation before laser-assisted cataract surgery should include a dilated eye exam, a computerized mapping of your corneas, measurements of your eye to customize your lens implant, and, oftentimes, a scan to check for any problems with your macula, a part of the retina.

You'll be given drops to numb your eye, and you'll remain awake, but sedated, during the outpatient surgery. Afterward, your vision may be blurry, but it typically clears up within one to seven days.

About 1 to 2 percent of cataract surgery patients experience complications, such as infection, retinal detachment or the need for further surgery, Dr. Millstein explains. Men taking certain drugs for benign prostate enlargement--such as alfuzosin (Uroxatral[R]), tamsulosin (Flomax[R]) and silodosin (Rapaflo[R])--may be at greater risk of complications during cataract surgery, so tell your surgeon if you're using one of these drugs.

Overall, cataract surgery remains one of the safest and most effective operations, Dr. Millstein says.

"Laser cataract surgery is the huge revolutionary change that's happened in the last few years," he says, "and it's going to continue to grow."


* Undergo a comprehensive eye exam yearly after age 65 or more frequently if your physician recommends it.

* Work with your doctor to lose weight, control your blood pressure and blood sugar, and, if necessary, stop smoking. High blood pressure, diabetes, and smoking are significant risk factors for cataracts.

* Protect your eyes from sun exposure by wearing sunglasses that block 99 to 100 percent of the sun's ultraviolet rays.

* Before undergoing laser-assisted cataract surgery, ask your specialist these questions:

** Which type of cataract surgery--laser-assisted or standard--is best for me?

** How significantly will my vision improve with laser-assisted cataract surgery compared to standard cataract surgery?

** What is my risk of complications from laser-assisted versus standard cataract surgery?

** How much more does laser-assisted cataract surgery cost compared to standard cataract surgery? What out-of-pocket expenses will I incur from choosing laser-assisted cataract surgery?
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Title Annotation:Vision
Publication:Men's Health Advisor
Date:Jul 1, 2014
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