Treatment Options

For early-stage cataracts, a change in the strength of your prescription (glasses, bifocals, or contact lenses) or the use of a magnifying lens may improve your vision enough to allow you to do the tasks you like to do. Surgery is indicated when you cannot carry out your normal day-to-day work or leisure activities because your vision is too poor, even with corrective lenses.

Types of Cataract Surgery

Cataract surgery is one of the safest outpatient procedures performed in the United States. Thanks to technological advances in intraocular lens (IOL) implant design and surgical devices like the femtosecond laser, today’s cataract patients undergoing surgery may experience better outcomes and less disruption to their lives. A safe and reliable procedure is potentially even better: Incision sizes are smaller, which promotes faster healing, while laser use reduces the surgeon’s reliance on handheld tools and blades.

There are two components to the surgery: removal of the clouded crystalline lens and insertion of an artificial lens (intraocular lens implant or "IOL").

Blade-Free, Image-Guided, Fully FDA-Approved, Laser-Assisted Cataract Surgery

Since the mid-1990s, blade-free laser technology has transformed eye surgery to correct refractive errors such as astigmatism, near-sightedness, far-sightedness, and presbyopia ("over-40" eyes). Fortunately, fully FDA-approved femtosecond lasers like the LenSx® system bring the customization, precision, and safety associated with LASIK into the realm of cataract surgery.

UT Southwestern Ophthalmology is the first practice in Dallas to offer blade-free, image-guided, fully FDA-approved, laser-assisted cataract surgery, the next step in the optimization of cataract treatment and astigmatism correction. Astigmatism occurs when, instead of being round, the cornea (or, at times, the lens) is shaped like a football. Light cannot properly focus on the retina, which results in blurred vision.

In laser-assisted cataract surgery, the surgeon uses the laser and its computer to perform some of the most critical stages of the operation, including the incision and opening to remove the clouded crystalline lens. Research indicates that this method may be more accurate than the manual incision performed in traditional cataract surgery and results in a more accurate insertion of the replacement lens. Extracting the cataract through the opening is made easier, too, because the laser breaks up the lens into smaller, more pliable pieces. The improved incision technique and extraction may help patients recover sooner.

However, not all patients are good candidates for laser-assisted cataract surgery. Your ophthalmologist will discuss which treatment options are best for you.

Traditional Cataract Removal

The most widely used method of cataract removal involves the surgeon making a small incision in the eye with an instrument about the size of a pen tip. Next, the physician uses ultrasonic energy to break up the cataract so it can be removed through the incision, often less than 3 millimeters in length. This part of the procedure is called phacoemulsification (pronounced FAY-co-ee-mul-sih-fih-CAY-shun). Once the clouded crystalline lens has been removed, the surgeon inserts an artificial IOL into the eye through the same small incision.

As with any surgical procedure, complications may occur during cataract removal. Be sure to discuss with your doctor all aspects of the procedure so you can weigh the risks and benefits of cataract surgery.

Intraocular Lens Replacement Options

Following the removal of the cataract, your surgeon will implant an artificial intraocular lens. Prior to today’s multifocal lenses, the objective was to treat the cataract and restore vision with a monofocal IOL. With this lens, the patient must wear glasses for the rest of his or her life.

The development of astigmatic (toric) lenses provides better distance vision with glasses than conventional IOLs. Today’s presbyopia-correcting multifocal IOLs have transformed patients’ options following cataract removal, allowing them to focus on objects at near (reading/sewing), middle (computer), and far (movies/driving) distances. Some patients find they no longer need glasses or contact lenses following the insertion of multifocal IOLs in both eyes.

ReSTOR® is one type of multifocal permanent artificial lens. Made of soft plastic, the ReSTOR® lens is folded and inserted into the eye through a tiny incision, smaller than the optic diameter of the lens. Once inserted, the lens gently unfolds to restore vision.

Clinical Results

  • Clinical studies have shown that the ReSTOR® IOL provides good near, intermediate, and distance vision without the need for glasses or contacts.
  • 75 percent of patients with ReSTOR® lenses report that they never need glasses or contact lenses for any activities. They can read books and the computer screen, drive a car – day or night – and play golf or tennis with freedom from glasses.
  • 94 percent of patients were so pleased with their vision that they would have the ReSTOR® implant again, if given the chance.

Our physicians implant a variety of IOLs to provide you with the best customized treatment for lens replacement, including Crystalens®. Your doctor will discuss all options with you.