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Cataract Surgery

Cataract surgery is one of the safest, and most commonly performedsurgical procedures. It's also one of the most successful. In the vast majority of cases, patients do well and achieve excellent vision. A cataract is the clouding of the natural lens in your eye. This lens functions to focus light. When this lens becomes cloudy, it causes many symptoms such as blurred vision, glare, the need for increased lighting to read, and starbursting when driving at night. Fortunately, cataracts can be quickly, safely and permanently removed with cataract surgery.

However, all cataract surgery and all cataract surgeons are not the same.  At Central Florida Eye Specialists, Drs. Barber and Cordero invest in the latest cutting edge technology.  We were the first to bring Lensx laser cataract surgery to our area.  Laser cataract surgery offers improved safety, and increased precision compared to manual surgery. Laser cataract surgery is able to reduce astigmatism, and is a Customized Bladeless procedure. We also use the verion digital marking system to improve our patient’s post operative outcomes.  Dr. Barber mentors and teaches surgeons how to use the Lensx laser and verion digital marking system.

quoteThe care of my elderly parents has been wonderful - special care taken with them and their disabilities and my care has been tops. Thank you, thank you, thank you.quote
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We also use Droplesscataract surgery, where medications are placed in the eye at the time of surgery to reduce or eliminate post operative eye drops, thus saving our patients time, money and inconvenience.

Drs. Barber and Cordero spend ample time with each patient to ensure the right technology is used for the right patient.  There are many options in cataract surgery and it takes time getting to know each patient’s lifestyle and goals before making these decisions.  We avoid the assembly line  mentality of practice and pride ourselves in giving each patient the individual attention they need.

Watch the videos below to learn more about cataract surgery.

"Cataracts" by Dr. Barber
"Cataracts" by Dr. Barber

Frequently Asked Questions (FAQ):

1. How is Cataract Surgery Performed?
Cataract surgery today is quite comfortable. First, the procedure will begin with your eye being treated with an anesthetic so that you will feel little if anything during your surgery and minimal if any discomfort.

Your eye surgeon operates while looking through a highly specialized microscope, designed exclusively for this purpose. A very small, beveled incision, less than 1/8 of an inch, is made at the edge of the "clear cornea". The clear cornea is the transparent covering of the front of the eye.

The incision is just large enough to allow a microscopic instrument the size of a pen tip to pass through it. Once the microscopic instrument is actually passed through the tiny incision, ultrasound from the tip of the microscopic instrument will be used to gently break the cataract into pieces small enough to be washed away, drawn through the instrument and removed from the eye.

Through the tiny incision, a microsurgical, ultrasonic, oscillating probe is inserted, which gently fragments the cloudy lens, using high frequency sound waves. Simultaneously, this same instrument suctions out the fragmented pieces. This process is called "phacoemulsification". The posterior capsule, an elastic bag-like membrane that held the lens, is left in place.

The incision is commonly called "self-sealing" because the eye's natural internal pressure holds the incision tightly closed allowing the eye to heal without stitches. The chances of developing astigmatism (distorted vision) after surgery are significantly decreased by eliminating stitches, which tend to pull the eye's surface slightly out of its natural shape.

Once all the minuscule bits of the cataract have been removed, a tiny new clear implant lens is folded, inserted through the small incision, and allowed to open up inside the posterior capsule.

The surgery typically takes 20-30 minutes, and is performed on an outpatient basis. This means that you will have the surgery and then go home, usually around 30 minutes afterwards. Most of the time only local anesthesia is used, so you will be awake for the entire process. After the surgery, you are taken to the recovery room and then released. You will need someone to drive you home.
2. Are Lasers Used to Remove Cataracts?
No — Lasers are not part of a cataract operation. Cataracts are removed using ultrasonic sound waves, not laser light. However, lasers are used for the removal of "capsular haze", which is a thin film of scar tissue that occasionally forms on the posterior capsule behind the new implant lens. This haze is harmless and painless, and it occurs in a small percentage of cataract surgery. Patients sometimes think their cataract has "grown back", but it hasn't. Once a cataract has been removed, it will not reoccur.

A special YAG laser is used to remove capsular haze by the following — An opening is made in the scar tissue with the laser, allowing vision to be restored. With modern intraocular lens implant designs, and materials, the incidence of posterior capsule clouding has fallen to approximately one percent.
3. Is Cataract Surgery Painful?
It is perfectly normal to be a bit apprehensive before any unfamiliar experience. All this information about cataracts and surgery may seem odd or a little frightening to you. That's okay because we are here to walk you through it and make everything as simple and smooth as possible.

Our patients most often report that their surgery was remarkably pleasant, and that pain was not even a consideration. Some have even told us that they haven't felt that relaxed in years!

At Central Florida Eye Specialists and Laser Center, we promise to be attentive to your needs and well-being and will do everything possible to make sure you are completely comfortable throughout the entire procedure. You will be given a relaxant to enhance calmness and will neither see nor feel any part of your eye surgery. After you are released, we will call you that evening to see that you are doing well. The same afternoon or next morning, you will visit with your physician for evaluation and to address any concerns you might have. We are always here for you.
4. Can Both Eyes Be Done Together?
No. Cataract surgery is best performed on one eye at a time, to enable you to use one eye while the other is healing. They are typically scheduled two weeks apart.
5. How Long Do Lens Implants Last?
Assuming your eye is normal and healthy, the intraocular lens implant should last your entire lifetime. Lens implants are not known to "wear out."
6. What are the Risks of Cataract Surgery?
Cataract surgery is one of the most successful of ALL surgeries, but as with any surgery, there are some risks involved. The only way to avoid all risk is to do nothing. Complications are possible during or after cataract surgery even with the most excellent care. Those complications most commonly seen are associated with unusual eye anatomy (very long or very short eyes), certain inherited eye diseases, and prior trauma. Such complications include bleeding, infection, glaucoma, corneal clouding, swelling of the center of the retina, retinal detachment, decreased vision, or in exceptionally rare cases, loss of the eye itself. While it is impossible to predict in which patients these complications will occur, the risk of these complications is very small.

There are times when a cataract can be removed successfully but vision is not improved — because of other conditions or diseases of the eye. One such disease is macular degeneration, where the central part of the retina — the area that is critical for "fine" seeing — is damaged. Occasionally, macular degeneration cannot be diagnosed prior to the cataract removal because the presence of the cataract itself may prevent seeing the macula in sufficient detail. It is sometimes only after the cataract is removed that macular degeneration is diagnosed.

In addition, other pre-existing conditions of the eye can limit vision after cataract surgery, such as diabetic retinopathy or glaucoma.  All such pre-existing conditions limit the eye's ability to regain normal vision, even if the cataract surgery itself is a huge success.

All that said, remember that cataract surgery has a high success rate, higher than any other surgical procedure. It is most likely that your vision will be remarkably better and that your quality of life improved.
7. What Is the Cataract Recovery Time?
Not so long ago, cataract surgery involved making an incision large enough to remove the clouded lens in one piece. Patients often stayed at the hospital overnight or for several days. With the aid of new technologies, now cataract surgery can be performed through a very small incision and usually occurs on an outpatient basis, with a significantly shorter recovery time.

The afternoon of your surgery or the day following, you will have an office appointment to ensure that you are healing properly. Your vision could be blurred from ointments associated with eye surgery or you might see quite clearly. Every patient is an individual and heals somewhat differently.

Over the following weeks, visual clarity progressively improves, and after one month, the eye is typically healed and ready for refracting for new glasses, if needed. Follow-up visits are usually scheduled for the next day, one week, and then one month after surgery. During this time you will be using eye drops to help the eye to heal and to prevent infection.
8. Will Cataract Surgery Impact on My Activities?
Your sight will usually improve within a few days, although complete healing may take several months. It is a good idea to have some help at home if you can, especially if you find it difficult to put your eye drops in.

For the first four days following cataract surgery, we ask you to avoid any and all heavy lifting or bending over that bring your head below the level of your heart. After that, and for the month following surgery, you can resume most of your normal activities, but minimize lifting, bending, and straining. Carrying reasonably lightweight objects, such as a purse or a small bag of groceries, is usually fine.

You will also be asked to avoid getting water in the operated eye for one to two weeks. Avoid swimming. Water that is normally safe for showering and drinking has bacteria in it, and this can possibly cause an infection where the incision was made in your eye. Just adjust your routine to wash your hair leaning backwards rather than forwards or have someone else wash it for you.

You don't need to stay indoors, but try to avoid being out in the wind, as something might blow in your eye. You'll need to keep your hands out of your eyes as well. Your surgeon may give you an eye-shield to wear at bedtime to inhibit possible rubbing or pressing on the eye in your sleep. Avoid eye make-up for six weeks. As for returning to work or driving, this varies from one patient to another and the kind of work involved. Discuss your situation with your doctor who is here to address all of your concerns.
9. Will I See Better After Cataract Surgery?
Well over 95% of cataract surgeries improve a patient's vision. If having a cataract is the only cause of your decreased vision, removing it will improve clarity. If you have an additional problem (such as macular degeneration, prior uveitis, retinal detachment, diabetic retinopathy, or glaucoma), a determination will be made by your ophthalmologist as to which issue needs to be addressed, and when. Cataract surgery can be successfully carried out even in the setting of most of these other eye conditions.
10. Will I Need Glasses After Cataract Surgery?
Depending on your eyes and refraction, and the type of lens implant that is chosen, you may or may not have to wear glasses for reading or distance.
Once a cataract has been removed, light can once again pass undistorted through the cornea and the newly implanted artificial lens, to the retina in the back of the eye. However, you may still be required to wear glasses to see more clearly because the incoming light needs to be focused directly on the retina. If you eye cannot do so on its own, eyeglasses will be needed to provide that focus.

In addition, the implanted artificial lens cannot change shape for close vision the way a natural, youthful lens does. A natural lens accommodates, or changes shape, to bring objects into focus at distance, or close up. The intraocular lens implant provides clearest vision at a single focal distance, with the great majority implanted to correct for distance vision. This means that an eye focused for distance will have sharpest vision for activities such as driving, but, if you do not qualify for an accommodating lens implant, you would still require bifocal lenses or reading glasses in order to see clearly at close range.
11. How Do I Prepare for Surgery?
A comprehensive eye examination is the first step. During your examination for cataract surgery, you will be evaluated for any special medical risks. Your eyes will be measured with the most up-to-date technology, including the IOL Master, to determine the proper power of the intraocular lens that will be inserted during surgery. Be sure to inform your eye surgeon of all medications you are presently taking, and ask if you should continue your usual dosages. When your cataract surgery date is set, you will be given a simple list of preoperative instructions.

Questions to ask your cataract surgeon:

  1. Will the surgeon examine my eyes prior to surgery?
  2. Does the surgeon perform small incision surgery?
  3. What type of anesthetic will be used? Topical (drops only) or injections?
    1. If you are sensitive to light or have trouble keeping your eye open you may be more comfortable with injections for your surgery
  4. What type of intraocular lens (implant) will be used? Will it be a foldable implant that can be inserted through a small incision or a larger hard plastic implant that will require a larger incision?
    1. Larger incisions increase the likelihood of wound leaks and thus infections that could result in the loss of the eye. If a larger incision is necessary it should be closed with a suture.
  5. Is the surgeon on the active staff at a local hospital?
  6. If urgent medical problems arise during surgery, is the surgeon able to admit me to the local hospital or will I just be sent to the emergency room and not see the surgeon in the hospital?
  7. Is the surgeon (or another ophthalmic surgeon) available after hours and on weekends for emergencies?
  8. Will I see the surgeon after the procedure or will he be in a hurry to go onto the next operation?
  9. Will the surgeon personally do the post operative care?

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