CATARACT SURGERY
OVERVIEW | TOPICAL ANESTHESIA | CLEAR CORNEA INCISION |
PREMIUM LENSES | 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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Premium lenses
Traditionally, a mono-focal lens is placed in the eye during cataract surgery. Following surgery, the patient will need glasses to fine-tune the vision and allow the patient to see far, intermediate and near. Preimum lenses are new generation lenses that allow patients to become less dependent on glasses. These lenses are specially designed to allow patients to see certain distances in focus without the use of glasses.

Toric lenses are designed to eliminate or significantly decrease the amount of astigmatism, or warping of the cornea surface. The amount of astigmatism reduced is extremely accurate and stable. By using a toric lens, the vision without glasses is improved because the distortion from astigmatism is improved.

Aspheric lenses are designed to remove spherical aberration present in the cornea. Typically spherical aberrations do not affect vision in normal daylight, but as the pupil dilates in night vision, the image becomes less clear. The amount of spherical aberration varies from patient to patient and from eye to eye. Dr. Decker and Dr. Yang can measure the amount of corneal spherical aberration present in a patient and chose a lens that best suits the eye, resulting in the most optimal visual results.

Multi-focal lenses are becoming more popular, as they allow images at different distances to be seen in focus. Working distances of patients now include far (driving), intermediate (cell phones, computers), and near (reading). These lenses bring these various distances in focus, thus, decreasing the need for distance or reading glasses. These new lenses include the the ReZoom® lens, the ReSTOR® lens, and the Tecnis® lens.

Accommodating lenses dynamically change their shape to allow patients to see far, intermediate and near. The Crystalens® is the only accommodating lens approved by the FDA.

Dr. Decker and Dr. Yang offer all of the above premium lenses, giving patients the greatest flexibility in customizing the lenses that are best-suited to the patients' lifestyle and visual demands.
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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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