The #1 Cataract Care and Surgery in Tucson, AZ

Unless there is something extremely unusual about your eyes or your overall health, your cataract surgery will be performed as an outpatient surgery. This means that you will come in for the cataract surgery and go home the same day.

Your surgeon will conduct pre-operative measurements and discuss your lens options and desired vision outcomes at your initial evaluation.

The day of surgery, before you leave home, you will use eye drops to dilate your eye and start preparing it for the procedure. After your arrival at the surgery center, your eye surgeon will use local anesthesia drops to numb your eyes for surgery.

After your eye is dilated and prepared for surgery, the surgeon will begin your procedure while you are given conscious sedation instead of general anesthesia.

Once adequate anesthesia has been achieved, the area around the operative eye will be cleansed for sterility and a surgical drape will be placed. A small device known as a speculum will then be placed to keep your eye open during the procedure. There will be no discomfort.

A small incision is then made in the cornea, or clear window at the front of the eye, and a viscous gel is injected into the eye in order to maintain space and protect the other ocular structures during surgery. The “main” corneal incision is then carefully made using an extremely sharp and precise blade made of diamond. Next, a circular opening is created in the front of the thin membrane, or capsule, which surrounds the lens, and fluid is injected inside to separate the entire lens from its attachment to the capsule.

The cataractous lens is removed using phacoemulsification, the amazing technology behind modern cataract surgery. The phacoemulsification machine produces ultrasound waves within a tiny handpiece, which is inserted into the eye. This causes the metal tip of the instrument to vibrate very rapidly, up to 40,000 times each second, dissolving the cataract material which is then aspirated out of the eye.

Additional instruments are used to clean all cataracts from the lens capsule, which is then refilled with more viscous gel.

An artificial, permanent lens implant, made of a type of plastic, is then inserted into the capsular “bag,” taking the place of your natural lens. This implant, which helps focus the incoming light on your retina, is held in place by two haptics, or curved arms. Once the implant is in place, the incisions are closed, usually without stitches, and the surgery is complete. Learn more about your lens options here.

Your eyes should start healing and your vision will improve within two to five days following your cataract surgery. At first, your vision is likely to be blurry but that blurriness will gradually become sharpened. You will be given an eye drop schedule and following it is vital to the success of the surgery and to reduce the possibility of infection post-operatively. You will be seen by your surgeon the day after your procedure and then have a follow-up visit within 10-14 days to check on the health of the eye and if necessary, to prepare for the second eye surgery. Very rarely problems may occur following surgery. One such problem or risk is the development of residual astigmatism following the surgery, which can be corrected and your surgeon will discuss the options with you.

You will return to our office the following day for a postoperative examination. The flap will be checked to assure that it is healing properly. If present, the contact lens will be removed at this time. Vision at this time is usually between 20/20 and 20/40, depending on the degree of refractive error corrected. Vision may continue to improve over the next few weeks before stabilizing fully. At this point, you should be able to go about your business as usual… with one exception- no more glasses or contact lenses!

Specific genetic disorders can play a role in the development of cataracts. As the genetic disorder develops and progresses, it can create the right conditions for cataracts to form.

There are other contributing factors that lead to the development of cataracts: diabetes, smoking, obesity, eye injury, excessive alcohol, high blood pressure, prolonged exposure to certain medications, eye surgery, and age.

Nearly everyone develops cataracts over time, though the rate at which the lens undergoes these changes is quite variable. Some may note significant visual disturbances in their 40s, while others may live into their 80s and never be very bothered by their vision.

The reasons for these differences are not well understood. Genetics may play a part, with some simply more susceptible to cataract at an earlier age. Environmental factors, such as exposure to sunlight or certain diets, may one day be found to play a role, however current data regarding the effects of these elements are not conclusive.

No. Your eye surgeon will put anesthetic drops in your eyes prior to your procedure to ensure you feel no pain. If you feel discomfort after the procedure, we can prescribe drops to minimize your discomfort and expedite your healing. Most patients feel fine within a few days.

The implant can be chosen to focus your eye at any distance you desire. While most choose to focus at distance, some prefer to see most clearly at near, particularly if they have always been myopic, or nearsighted.

At Oracle Eye Physicians & Surgeons we perform these measurements with the Zeiss IOL-Master, the most advanced, accurate device for this purpose, which uses a laser to scan the eye in just seconds.

While these calculations are extremely accurate in most cases, the expected results are not always achieved. Most patients obtain vision good enough to drive without glasses.

Rarely, the post-operative refraction (eyeglass prescription) will be significantly different than expected. In these unusual cases, additional surgery, including removal and replacement of the lens implant, may be required to achieve the desired result. The appearance of an implant in the eye at the end of surgery is shown right.

The majority of lens implants inserted during cataract surgery are considered ‘monofocal,’ meaning that they focus light at only one location, usually in the distance. This means that reading glasses will be required for close-up tasks such as reading- without them near vision will be blurred. Another option is the ‘multifocal’ lens implant. Such implants allow for clear vision at distance, as well as good vision at mid-range and near. Each type of lens has specific advantages and disadvantages. You can discuss these options with one of our physicians during your evaluation.

Once removed, a cataract does not return.
However, the backside of the lens capsule, which remains intact at the time of surgery in order to support the implant, can become cloudy over time. This opacification sometimes referred to as a “secondary cataract,” can affect vision much the way the cataract once did. If this occurs, a brief, painless laser procedure performed in the office can clear the opacity from the implant. The capsular opacification does not recur once this is performed.

In early life, most astigmatism is due to an irregular shape of the eye, in which the cornea is steeper in one meridian than the other. As we age, many develop astigmatism due to irregular thickening of the lens as cataracts develop. This latter form of astigmatism will disappear when a cataract is removed, however, any remaining corneal astigmatism will blur vision, increasing the likelihood that glasses will be necessary for clear vision postoperatively.

Fortunately, for those who desire the best possible uncorrected distance vision after surgery, astigmatism can be reduced or eliminated surgically at the time of the cataract operation. This is performed in one of two ways, depending upon the amount of astigmatism present prior to surgery. For lesser degrees of irregularity, extra incisions called “limbal relaxing incisions” can be made in the cornea using a very precise diamond blade. These incisions serve to flatten the steeper meridian of the cornea, making it even in all directions.

For larger amounts of correction, limbal relaxing incisions are not enough to overcome the irregularity. In such cases, a special lens implant known as a “toric IOL” can be placed in the eye. Like eyeglasses, which are crafted with cylindrical lenses placed in a specific axis to correct one’s particular degree of astigmatism, a toric implant with the correct cylindrical power is carefully rotated into the precise position within the eye to neutralize corneal astigmatism.

Many often ask if cataracts can be prevented. Given our current lack of understanding of their causes, the simple answer is no. Some eye doctors advocate the use of ultraviolet light-blocking sunglasses. While not definitive, some studies have suggested that ultraviolet light may be partly responsible for cataract progression, as well as for other eye diseases such as age-related macular degeneration.

The use of sunglasses may therefore help and certainly will not cause any harm. Similar advice might apply to antioxidants such as vitamins A, C, and E. While studies have produced conflicting information, some indicate that these vitamins may slow cataract growth. Speak with your medical doctor prior to starting any high-dose vitamin program.

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