Deciding On Cataract Surgery… Is now the right time?

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Deciding On Cataract Surgery… Is now the right time?, The Women's JournalBy  Jeffrey B. Minkovitz, M.D.

Cataracts are part of the normal aging process.  The natural lens within all our eyes becomes more cloudy or discolored over time. This loss of clarity is called a cataract. There are numerous things we may be exposed to which contribute to cataracts, including smoking, diabetes, excessive sunlight, and certain medications. Typical symptoms include blurry vision, glare around lights at night, loss of color and contrast perception, and increased nearsightedness. While some loss of vision is inevitable, the question everyone must face is when is it time to act. The mere existence of a cataract does not require surgical intervention. Only the affected individual can decide when their vision loss warrants surgery. With today’s modern and successful cataract surgery techniques, not only is restoring vision possible, but oftentimes visual function can be improved to levels better than before the cataract formed. The surgeon can help to determine whether the loss of vision is due to a cataract, or due to another eye condition (such as macular degeneration or glaucoma). Certain conditions require prompt intervention to avoid irreversible damage, and therefore thorough and timely evaluation is important. Fortunately, cataracts usually only need surgery when vision loss interferes with one’s normal activities. Most of the time, patients know when they are ready for surgery: when they are no longer able to perform activities they enjoy doing – such as reading.  Occasionally, patients may be advised to act if the vision loss makes certain activities dangerous, such as driving a car.

Once surgery has been elected, the next decision is the type of intraocular lens to implant to replace the cloudy natural lens. New aspheric lenses give sharper vision allowing better contrast, but they are not for everyone. Your surgeon can help to determine if certain ocular conditions exist which would make such a lens less beneficial. There are also newer lenses, which can correct astigmatism, called toric intraocular lenses. These can allow greater freedom from wearing distance glasses following surgery. Other lenses offering greater freedom are those which enable patients to see far objects as well as close objects without the use of glasses. There are two different technologies which can achieve this goal, and a surgeon experienced in both can help their patients decide which is most appropriate. One type is called an accommodative lens, such as the Crystalens by Bausch and Lomb. The other type is a multifocal intraocular lens, including the Alcon ReStor lens and the AMO Technis multifocal. Both offer greater independence from glasses, with most patients no longer needing help to read. Each has its unique advantages and disadvantages. An experienced surgeon can help to choose the best alternative, and assure success with proper implantation.  Surgical technique is critical, and experience in refractive surgery (including laser vision correction) is helpful, as some patients benefit from further vision enhancement.

Modern cataract surgery has allowed patients to restore vision loss and even improve preexisting visual limitations. However, both the choice of implant, and the decision for surgery itself, requires careful evaluation and an informed patient. Only after careful consultation (including a thorough examination and a thoughtful discussion) with an experienced surgeon should surgery be chosen. Under the right circumstances, the results of modern surgery are brilliant.

Jeffrey B. Minkovitz, M.D., is with Eye Physicians and Surgeons, P.A., 1207 North Scott Street, Wilmington, DE 19806. Dr. Minkovitz is affiliated with Christiana Care, Wilmington, DE and The Center for Advanced Surgical Arts, Wilmington, DE. Dr. Minkovitz served as an Assistant Professor with Johns Hopkins University from 1998-2004. He received his M.D. in 1990, University of Massachusetts Medical School; and his B.A., Magna Cum Laude, Harvard University in 1986. Dr. Minkovitz received his certification in 1996 with the American Board of Ophthalmology and in 1991 received certification with the National Board of Medical Examiners. For six consecutive years, Dr. Minkovitz was awarded the distinction of “Top Doc” for excellence in the field of Ophthalmology in a survey of his peers. Dr. Minkovitz is a highly accomplished surgeon with over 13 years experience. Dr. Minkovitz  is fellowship trained in cornea, cataract, and refractive surgery. As one of Delaware’s leading cataract surgeons, Dr. Minkovitz offers both ReStor and Crystalens® to his patients.

For further information or to schedule an appointment please call 302-656-2020 extension 1.

Deciding On Cataract Surgery… Is now the right time?, The Women's Journal