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Cataract Patients Electing for Earlier Treatment, Upgraded Implant Lenses and Femtosecond Laser-Assisted Surgery

Carolyn Glazer-Hockstein, M.D., of Eye Physicians & Surgeons, and Fran Hershberger. Photo by Ron Dubick

Multifocal lens implants such as those that Williams received are among the more recent advances in cataract surgery that are making a big difference in patient lifestyle. A cataract is the clouding of the lens of the eye, and it cannot be corrected by glasses, contacts or LASIK. “It can be like you are looking through a window that gets progressively cloudy and dirty,” Sumlin explains.

Cataracts are the leading cause of reversible loss of vision in people over 50, according to Lebowitz. Although most often caused by aging, they can also result from cortisone medicine, trauma, diabetes and other diseases.

“There’s been a change in eye care, a paradigm shift. In the past, people waited until age 72 or 75 and had dense cataracts removed and lenses implanted that may or may not have provided eyesight that was good enough,” Sumlin says.

Now, cataract patients are more likely to elect to have surgery at an earlier age and they have the option to select newer, upgraded implants like multifocal lenses or, if they have astigmatism, toric lenses, both of which can reduce the need for glasses. In many cases, people can go without glasses. These upgraded lenses are covered only partially by insurance or Medicare and can cost the patient $1,000 to $3,000 more per eye, but many patients think they are worth it, Lebowitz says.

The newest change in cataract surgery is the introduction of femtosecond lasers to open up the cataract and defragment the cataract before dissolving it with high-frequency ultrasound. In most cases, however, lasers are not used and the incision is instead made with a microscopic blade and ultrasound is used to do the procedure.

Jaoude notes that the jury is still out on whether laser-assisted cataract surgery is “significantly more accurate,” than the current method, and that ophthalmologists are still awaiting the results of more studies.

Markowitz, however, believes it possible that within the next four or five years a large percentage of cataract surgery will be done entirely with lasers and eventually all procedures will be done that way.

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