CATARACT SURGERY
OVERVIEW | TOPICAL ANESTHESIA | CLEAR CORNEA INCISION |
MULTI-FOCAL LENS | LIMBAL RELAXING INCISION

Overview
Over the years, many advances have taken place in the field of cataract surgery. The newest techniques have become so refined that cataract surgery is now considered a refractive procedure, with the goal of not only removing the cataract, but also decreasing the patient's dependency on glasses.

A cataract is a lens that has become clouded. Many times, a patient will describe that looking through a cataract is like looking through a dirty window. During the cataract operation, a small ultrasound device is used to remove the clouded lens and a new, clear intraocular lens is inserted. Measurements of the eye prior to surgery are used to select the power for the intraocular lens that will make the patients least dependent on glasses.

Both Dr. Decker and Dr. Yang use the newest technologies available for cataract evaluation and surgery. Although applanation ultrasound can be used to determine which intraocular lens power to use, the most accurate refractive results are obtained when using the IOL Master and Immersion Biometry, both of which are utilized at the San Jose Eye Institute. Dr. Decker and Dr. Yang also exclusively use the Sovereign Phacoemulsification System with the latest WHITESTAR™ Technology. It is this machine that creates the ultrasound which breaks up the cataract into tiny pieces. The WHITESTAR™ upgrade reduces the total amount of energy used during the cataract extraction, resulting in a much quicker recovery time for the patient.
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Topical Anesthesia
The technique of using only eye drops to anesthetize the eye is a significant advance in cataract surgery compared to using a needle. Currently, only about 50% of the ophthalmologists nationwide are skilled in this technique. Without a needle, there is no risk for bleeding or having the needle penetrate the eye inadvertently. Following cataract surgery, patients with topical anesthesia can go home without any eye patch, whereas those who had a needle will be required to have their eye patched for 24 hours. Both Dr. Decker and Dr. Yang routinely use topical anesthesia in order to achieve the best results.
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Clear cornea incision
There are many techniques used to enter the eye in order to remove the cataract. The size and location of the incision can affect the curvature of the cornea and potentially induce astigmatism. This can be minimized by having a smaller incision. Incisions in the sclera (the white part of the eye) are typically 6 mm in length, whereas incisions in the clear part of the cornea can be as small as 2.5 mm. These corneal incisions are so small, that they usually do not even require sutures to close the wound.

Furthermore, unlike cutting in the sclera, there is no bleeding associated with making an incision in the cornea. As a result, without using a microscope, it is difficult to tell that surgery was even performed.
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Multi-focal lens
Traditionally, a mono-focal lens is placed in the eye during cataract surgery. The power of this lens is usually chosen so that the patient will have good distance vision without glasses. This would mean that the patient would need reading glasses for intermediate and near vision. A new generation of multi-focal lenses can now be implanted into certain patients. These lenses are specially designed to allow images at different distances to be seen in focus, thus, decreasing the need for distance or reading glasses. These new lenses include the the ReZoom® lens and the ReSTOR® lens.
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Limbal relaxing incision
This is a technique similar to astigmatic keratotomy which can be used to decrease the amount of corneal astigmatism. A corneal topography is used prior to cataract surgery to map the extent and location of the astigmatism. Based on this map an incision is made on the cornea to neutralize the astigmatism. Reducing the astigmatism at the time of the surgery will further reduce the patient's dependence on glasses.
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