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Cataracts

Cataract Surgery

Cataract surgery used to be a very complicated procedure, but with the advent of phacoemulsification pioneered by Charles Kelman, M.D. in the late 1960s and early 1970s, modern cataract surgery is much safer, simpler and effective. According to the American Academy of Ophthalmology, more than 3 million patients have cataract surgery each year making it one most common surgery performed in the United States. With modern advances in cataract surgery techniques, the surgery has become an outpatient procedure, which typically takes about ten to fifteen minutes to complete. Surgery is performed through a micro incision and there are typically no sutures used in the eye. The eye is left without a patch only being shielded with a clear shield for the first 24 hours. Dr. Duzman has performed thousands of cataract surgeries and is an expert in the field.


Understanding Cataracts


Cataract Surgery
Cataract Surgery
Cataract Surgery
Cataract Surgery
What to expect during Cataract Surgery?

A cataract is a gradual clouding of the eye’s natural crystalline lens. The lens assists with focusing light rays onto the retina, which communicates images to the brain. After the cataract starts to cloud the lens, it is impossible to return the lens to its clear state with medications and may require cataract surgery. Various factors may cause cataracts including cigarette smoking and diabetes.  Other factors such as obesity, prolonged exposure to sunlight, alcohol and smoking have been listed by the National Eye Institute as having the potential to increase cataract formation.

Most cataract patients with early cataracts are unaware that they have them. Patients tend to accommodate to the changes that so gradually occur in the vision as the cataract forms. For most patients, symptoms of a cataract are vague but include decreased vision, glare, dullness of colors, and problems with night driving. Cataracts are a progressive condition that will eventually lead to diminished ability to perform activities of basic living. During your visit with Dr. Duzman, please mention any concerns that you have regarding your visual symptoms. Dr. Duzman will evaluate your cataract during each visit and advise you when he thinks that surgery is warranted.


Dr. Duzman used the most advanced microsurgical techniques. He uses a procedure called phacoemulsification. This procedure used high frequency ultrasound waves to gently remove the cloudy lens from the eye. This is the simplest, safest, and most successful cataract treatment available today.


During cataract surgery, the eye is dilated with eye drops. Intraveinous medications are given to induce twilight sleep however you are still in full control of your actions. The eye is cleaned with betadine solution. Anesthesia is given in the form of drops and an eye gel. A 2.2 millimeter incision is performed through which the ultrasonic phacoemulcification device is inserted. The lens of the eye is located behind the pupil. It sits in a capsule. Dr. Duzman carefully opens the front portion of the lens capsule gaining access to the lens material. The lens material is then gently aspirated from the eye using the ultrasound tip. Finally, the lens, chosen by Dr. Duzman specifically for you, is delivered into the eye using the same small incision. The lens is then centered in the capsular bag. The lens will remain inside your eye in this location without moving, and cannot be felt or sensed in any way. The incision is then checked for water tightness and a clear shield is placed on the eye.


Once surgery is done, you will be spend approximately a half an hour in the recovery room and go home.


After Cataract Surgery

Recovery from surgery is generally very quick, with most patients achieving noticeably better vision within the first 24 hours of the procedure. Patients are generally asked to use several eye drops after surgery for a period of 1 month.  The first two weeks after surgery are critical for a quick recovery as patients must refrain from strenuous activity such as heavy exercise or any strain. Patients should also refrain from eye rubbing during the first few weeks following surgery.


Introduction to Premium Lens Implants

If you are nearing the age for cataract surgery and want a reliable vision correction solution, premium lens implants are another option. Premium lens implants have helped patients achieve the goal of independence from glasses or contact lenses. Imagine playing golf or reading the newspaper without depending on glasses, a life without them could dramatically impact your overall happiness. This is why the doctors at Lakeside Vision Center have been trained in the latest intraocular surgery techniques involving lens implantation with multifocal, accommodating, and toric lens implants, also referred to as premium lens implants.


Who is a multifocal lens candidate?

The multifocal and accommodating lens technologies are suited for the majority people but some eye conditions may make the surgical results less that optimal. In these cases, Dr. Duzman may recommend against using a multifocal lens. It is commonly agreed among eye surgeons that people with the following conditions be warned about the use of a multifocal lens.

  • People with unrealistic expectations about their results
  • People with psychiatric disorders
  • People with a history of glare in night vision even when they did not have a cataract
  • People with advanced glaucoma and most macular disease patients
  • Patients with Macular Disease


Choosing Your Lens Implants

Once the cataract is removed, a clear artificial lens implant, intraocular lens (IOL) will be placed in your eye. If your eye is healthy, you have a choice of several types of implants to be placed into your eye.  Depending on the refractive state of your eye, you may have an option of a monofical, multifocal or torric (astigmatism correcting) implant. Dr. Duzman will discuss these options with you in the pre-operative period. The new premium IOLs have advanced designs to give our patients the ability to see near and far with reduced dependence on glasses. Our doctors realize each patient has unique visual requirements and will customize the lens implant based on a comprehensive examination of your eyes.   


Tecnis® Multifocal 

This lens has been long awaited by American surgeons. It has been used in South America and Europe with great success for several years. In the early parts of 2010, this lens was approved by the US FDA. The platform on which this lens sits has been successfully used in the US for many years and has an excellent safety profile. Dr. Duzman was one of the first surgeons in Orange county that has embraced this technology and has many happy patients that have benefited from this technologically advanced lens.

The Tecnis multifocal is a stationary lens that distributes the incoming light onto the retina so that patients can see near, intermediate and far. It is technologically superior to other available lenses because it allows patients to see clearly in all distances independent of lighting conditions. This means that whether you are out golfing in the bright sunlight or having an intimate candle lit dinner, vision clarity is maintained. The lens design also proves to have a lower incidence of halos and glare that may occur with all multifocal lenses. Our current experience with the lens and the FDA data supports that many patients can reduce or eliminate their use of glasses for everyday tasks.

Since its approval in 2010, this is Dr. Duzman’s preferred lens. Only with a thorough evaluation of your eye will Dr. Duzman be able to custom fit a lens for you.

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ReSTOR® - Multifocal IOL

The Acrysof® Restor® IOL was one of the first premium lens implants that achieved a high level of success. We have many happy Restor® patients and many patients speak highly of this implant.  Many patients that wore glasses for years don't wear them anymore thanks to Restor®.  The FDA data indicates that 80% of patients were spectacle-free after cataract surgery with this lens implant when implanted in both eyes. The lens does help people requiring surgery in only one eye but acheives greater success when the lens is implanted bilaterally. 

The Restor lens is particularly helpful for people who have hobbies and interests that are up close in nature. This includes reading, small crafts etc.

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Crystalens

Crystalens

Crystalens®HD® – Accommodating IOL

The natural lens of the eye moves to allow us to focus on objects at different distances.  As the eye ages, the lens gets harder and looses some of its ability to focus.  Most people notice this process around the mid-40’s as it affects their reading abilities. This is called presbyopia.  After cataract surgery, you can have a lens implanted that can correct presbyopia in a similar manner as your natural lens by moving inside the eye.

 

The Crystalens is the first FDA-approved artificial accommodating intraocular lens designed to address the effects of presbyopia.  It is the only intraocular lens that uses the natural focusing ability of the eye to restore vision for distance intermediate and near tasks.  Similar to the young lens, the Crystalens will actively adjust to your visual needs.  It is the only FDA-approved presbyopia correcting IOL for cataract patients that does not split the incoming light rays and results in a continuous range of vision. 


The Crystalens has been a very successful lens for those patients whose life styles involve distance and intermediate tasks. It is a great lens for people whose life requires night driving. Some Crystalens patients are able to read the newspaper and reduce their dependency on glasses. Most Crystalens patients are able to see their computers and dashboards without glasses. More than twice the number of patients implanted with Crystalens could see well at all distances compared to a standard IOL.

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