About Our Cataract Surgery Services
What to Expect
Did you know that cataracts will affect over half of all adults over age 60? A cataract is a gradual clouding of the natural lens of the eye. The most common symptoms of cataracts include halos and glare with headlights at night, reduced depth perception, annoying glare in sunlight, diminished color perception and poor night vision.
Dr. Auker is a Board Certified Ophthalmologist. He performs cataract surgery by the most modern techniques anywhere in our offices in Pleasanton, California. The lens is removed and replaced with a foldable implant through a tiny incision in the clear cornea under local anesthetic in a painless procedure that is completed in minutes.
Is cataract surgery safe and effective?
Cataract removal is the most common operation performed in the U.S. today. It is also one of the safest and most effective. It is our expectation that all patients will appreciate the improvement in their visual functioning following cataract surgery. Dr. Auker has over 20 years of cataract surgery experience.
It is his passionate goal to continue to have happy and satisfied patients. While the above statement is intended to reassure prospective cataract patients, no surgeon can guarantee success for any individual patient. Every intraocular procedure carries with it the possibility of vision loss due to infection, bleeding, or other rare causes. Dr. Auker encourages his patients to proceed confidently in their decision-making as supported by his own experience and outcome analysis.
How is a cataract removed?
Dr. Auker has utilized and perfected these techniques since their inception and performs 99% of his surgeries via these methods. Phacoemulsification allows the cataract to be removed via tiny 2.75 mm slit incision in the clear cornea that forms the clear dome the colored iris and pupil at the front of the eye. Typically, the procedure is done with the patient under mild sedation and only anesthetic drops applied to the surface and interior of the eye are required to provide complete comfort during the case.
No injections or needles are required for the vast majority of patients.
The phacoemulsification device emits ultrasound waves that soften and break up the cloudy center of the lens so that the tiny particles can be removed by suction. This technique allows the use of the tiny incision and minimal disruption of the integrity of the eye. After removal of the cataract lens, an intraocular lens is placed in the same location as the removed material. This clear, man-made lens is flexible and becomes a permanent part of the eye.
It replaces the natural focusing power of the natural lens allowing most patients to see well after surgery without spectacle correction. Without the lens implant, one would have to wear very thick glasses or contact lenses in order to see well. The new intraocular lens is imperceptible soon after the surgery and becomes as stable and secure as the natural lens was within weeks. Occasionally, in the first few weeks after cataract surgery, a glimmer or reflection will be detected off to the periphery before the lens is firmly sealed in the contracted capsule or membrane that once contained the natural lens material.
What happens before surgery?
Once you have decided to proceed with cataract surgery, precise measurements need to be taken of the eye. Corneal curvature and length of the eye will determine the strength of the implant placed into the eye. Our outcome analysis assures the best possible statistical accuracy of this calculation. This accuracy provides for the best possible uncorrected vision.
Despite our meticulous efforts, every eye is unique, and the measurements are subject to standard deviation. For some patients, correction of the vision with glasses, contacts or laser vision correction may be necessary following cataract surgery.
You will need medical clearance before undergoing cataract surgery. While cataract surgery is not an invasive procedure and puts little stress on the body as a whole, regulations and safety considerations demand this process of health assessment prior to surgery.
A recent EKG is also required for most patients. You will need to set up a pre-operative appointment with your primary care physician. Mild sedation relaxes one during any procedure and makes the experience an easier one. For your safety, our anesthesia Clear liquids may be taken up until 4 hours before surgery. No food is to be taken after midnight the night before surgery.
What happens during surgery?
After you arrive at the surgery center, you will be given eye drops to dilate the pupil as well as others to sterilize and numb the surface of the eye. You will be taken to the operative suite and mild sedation provided via an I.V. The area around your eye will be washed and cleansed. A small device known as a lid speculum will hold your eyelids open during the surgery and surgery will begin. The topical and intraocular anesthetic drops will numb the eye and can be supplemented as necessary.
The operation usually lasts less than 15 minutes and is performed with the patient lying flat. You will be awake and relaxed; or, conversely, you may have no recollection of the procedure. It is safest when the patient is alert enough to be aware that cataract surgery is being performed and can cooperate in maintaining a still position.
After the operation, a shield is placed over the eye to prevent inadvertent rubbing or trauma to the eye. You will be able to see out through the holes in the metal shield immediately after the surgery. You will be observed for an average of about 30 minutes following surgery before returning home to rest indoors. Because of the sedation and policies in place, you will not be able to drive home and you should make arrangements for a ride.
What happens after surgery?
t’s normal to feel itching and mild discomfort for a while after cataract surgery. Some fluid discharge is also common, and your eye may be sensitive to light and touch. If you have discomfort, Tylenol is usually effective. Significant discomfort is not normal and should be reported immediately. You will leave the shield in place until the post-op visit the following day. You will wear the shield at bedtime for one week. Avoid rubbing or pressing on your eye.
Problems after surgery are rare, but can occur. These can include elevated pressure, infection, bleeding, and inflammation. Pain, increasing redness, loss of vision, or a thick discharge are not normal and demand immediate attention. With prompt medical attention, these problems usually can be treated successfully.
Most patients experience immediate improvement of their vision. You can quickly return to many everyday activities, even if your vision is slightly blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask us about when you can resume driving and what should be done about your previous glasses. When you have healed, you will probably need a new lens for your glasses over the operative eye.
YAG Laser Capsulotomy
The lens of the eye is positioned in an elastic-like capsular bag, which holds it in place and serves as a protective barrier. During cataract surgery, the front portion of the capsule in opened so the lens can be removed and replaced with an intraocular lens.
In some instances, a person may experience blurred, hazy vision, a common condition known as posterior capsular haze (sometimes referred to as “secondary cataract”). An estimated 40% of patients who have cataract surgery will experience posterior capsular haze. It can occur months or even years after the surgery. The YAG Laser is sometimes used by doctors to treat this condition. This treatment is called YAG Laser Capsulotomy.
YAG Laser Capsulotomy is an in-office procedure, which only takes a few minutes and is entirely painless. After the eyes have been dilated, your eye doctor will use the YAG Laser to create an opening in the center of the cloudy capsule. The majority of patients will notice an instant improvement in vision, while others will experience a gradual improvement over a period of days. Following the procedure, your vital signs and intraocular pressure will be reviewed. You can return to normal activities immediately.
Lens Implant Options
During cataract surgery, the eye’s natural lens is removed and replaced with an Intraocular lens, or IOL. Since being approved by the FDA in 1981, IOLs have offered an effective alternative for cataract patients. Prior to the use of IOLs, cataract patients had to wear very thick eyeglasses or special contact lenses in order to see after the natural lenses were removed during surgery.
Types of Lens Implant:
TECNIS® Monofocal IOL
Tenics monofocal This is the First and Only wavefront designed IOLs approved by FDA for:
- Reduced spherical aberration
- Improved functional vision
- Improved night driving simulator performance
This type of monofocal IOL is offering patients vision at only one distance (far, intermediate or near), and still requiring them to use corrective lenses to compensate for other distances. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.
TECNIS® Multifocal IOL for Presbyopia
The advanced TECNIS® Multifocal is an implantable lens, empowering you with high-quality vision in any light condition, from near to far distances—and everything in between. It’s an advanced Implant that restores vision after cataract surgery and corrects presbyopia (the need for reading glasses). It delivers results superior to those of a standard multifocal lens and offers an excellent chance to become spectacle independent.
TECNIS® Multifocal IOL for Presbyopia
The proven performance of AcrySoft® IQ Toric IOLs provides cataract treatment and astigmatism correction in a single procedure. Featuring exceptional rotational stability and the greatest correction range available, more patients than ever can attain crisp, clear distance vision with reduced dependence on glasses with the AcrySof® IQ Toric IOL.
Astigmatism: This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.
Dr. Auker has extensive training in cataract removal, and he continuously strives to provide cataract patients with the safest, most pain-free recovery of vision possible. He will be the best eye doctor to help you with your cataract surgery decision. He will choose the best implant lens for you base on your individual need and lifestyle. Each patient at Auker Eye Institute is a V.I.P.!”
You can learn more about Lens Implant Options here.