Cataract Surgery


What is a cataract?

Contrary to popular belief, a cataract is not a type of “film” that forms over the surface of the eye. In reality, a cataract is a change in the clarity of the lens inside your eye, a gradual clouding that can make your vision less sharp over time.

You see, the eye works much like a camera, and like a camera, depends on a clear lens to properly focus images. A healthy, transparent lens absorbs light and accurately focuses it onto the retina (the back of your eye), providing a crisp, clear image.

As we age, however, proteins in the lens begin to clump together, forming opaque clusters. Over time, these protein clumps will eventually cloud the lens, allowing significantly less light to pass through. The small amount of light that does make it to the retina is diffused or scattered, leaving vision defocused. These clusters can also change the coloration of the normally clear lens, tinting it a brownish shade that affects color perception

What causes cataracts?

Although the majority of cataracts develop on their own, as part of the natural aging process, there are certain risk factors that can contribute to cataracts developing earlier, or at an accelerated rate.

Risk factors for cataracts include:

  • Trauma to the eye, including injury, burns or surgery
  • Toxins, including regular use of tobacco, alcohol or corticosteroids
  • Exposure to radiation, diabetes, hypothyroidism and glaucoma

Heredity can also play a factor in determining when cataracts will begin to form in your lenses.

What are the symptoms of cataracts?

Cataracts generally develop slowly and painlessly. In fact, you may not even realize that your vision is changing. Still, cataracts are the most common cause of vision loss in people 55 and over – sooner or later, you’re bound to experience one or more of the following symptoms.

Some symptoms of cataract development are:

  • Blurred vision – Blurriness is one of the earliest and most common signs of cataracts. Changing your prescription may help, but it can’t correct the problem permanently.
  • Faded or dull colors – Colors appear less vivid than they once were. Certain shades can become more difficult to differentiate from one another.
  • Poor night vision – At first, you may simply need more light to read. Over time, you may find it more difficult to see objects in the dark, particularly when driving.
  • Sensitivity to light – Lights may seem uncomfortably bright, or appear to have halos around them.

How common is this surgery?

Cataract surgery is the most common surgical procedure performed on adults in the United States. We are a Bausch and Lomb Center for Excellence in West Springfield, and as such we have an expert staff on hand to help with the procedure. The eye surgery is performed on an outpatient basis, generally it takes a half-hour or less, and recovery time is usually only a few days.

What can I expect the day of surgery?

Modern-era cataract surgery is considered a “day-stay” procedure. Most ambulatory surgicenters and hospitals will allow the patient to remain in their own clothes, with the addition of a gown, cap, and shoe covers in the operation room.
Patients can expect the trip to the surgicenter to last for about three hours. The procedure is usually performed under topical anesthesia and dilating drops. Additionally, an IV is placed to facilitate the use of sedation during the procedure.
After the cataract is removed, the intraocular lens is implanted, completing the surgery. You can view the procedure on our site. The surgeon does a final check to make sure that the lens is in a good position. The wound is tested to ensure that it is watertight, and that the lid supporting speculum is removed. Immediately following the treatment, the patient is monitored in the postoperative holding area until they are ready for discharge.

What is the cataract surgery procedure?

Cataract surgery is a two-step procedure—

1. First the eye surgeon removes your cloudy lens
2. Second, a new lens implant is inserted into your eye. The cloudy lens is removed with a tiny instrument that enters your eye through a small incision—usually one-eighth of an inch or smaller—and gently breaks the cataract into tiny pieces that are then removed from the eye with a miniature vacuum cleaner.

What happens after my cataracts are removed?

Once the cataract is out, you will need a new lens in order to focus after surgery. Once your cataract is out and your implant is in, the operation is over.

What is an Intraocular Lens?

Artificial lens implants—made of plastic-like materials—are used to restore your ability to focus after surgery. These implants come in many different strengths, like glasses, and before your cataract operation, we will perform several measurements to determine the appropriate lens implant strength for your eye.

What lens choices are offered?

Doctor Frangie is pleased to be able to offer his patients a number of choices for their implants, in an attempt to decrease dependence on spectacles and/or contact lenses, depending upon the specific characteristics of your eye, and your own personal visual needs.

1) SINGLE FOCUS IOL (INTRAOCULAR LENS IMPLANT) – This implant is considered the “standard” implant and its design has not significantly changed in more than a decade. Following placement, the Single Focus Implant will allow the eye to see at a single focal point (most patients see better at distance), but in order to see at intermediate (computer distance) or up close (for instance sewing or reading) the eye will require either a contact lens or glasses.
Most insurance companies pay for cataract surgery with single focus implants, subject to your carrier’s specific co-pays and deductibles.

2) ASTIGMATISM-CORRECTING IOL IMPLANTS AND SURGERY – Astigmatism is typically a lifelong condition where the cornea, the outer window of the eye, has an irregular shape which prevents light from focusing accurately on the retina – even after standard cataract surgery. In patients who are candidates, astigmatism may be corrected by either specific wound construction or a Toric lens implant or both. Rarely, some patients may require an adjustment of their implant or even more rarely another procedure such as LASIK to improve their final visual outcome. If further procedures to adjust/exchange your implant or procedure to fine tune your vision are necessary, they will be done at no additional charge to you.

It is important to understand that while Astigmatism-Correcting Surgery will improve your uncorrected distance vision (and in some cases your intermediate distance vision) you will still need reading glasses for tasks that are close – sewing, reading, model-building, etc.

3) MULTIFOCAL IOL IMPLANTS represent a major advancement in cataract vision correction. These lenses give recipients an enhanced “range” of vision so they have reduced dependency on contact lenses or glasses at almost all distances. While these technologies represent a definite improvement, it is important to realize that the implants will not give one’s eye the performance level of a normal twenty-year-old eye – the implants represent an improvement, not the fountain of youth! This new generation of implants typically allows patients to drive without correction, play golf without correction, use the computer without correction and reduce the need for reading glasses.

What should I expect post-operation?

Most people see better within a day or two after cataract surgery, but it is not abnormal or worrisome if your vision seems blurry for a few weeks after surgery as your eye heals.
We will prescribe some eye drops for the healing period after surgery, and if you need new glasses after surgery, these will be prescribed for you once your eye is completely healed, usually about a month after surgery.

What are the Post-Op complications? Can my cataracts come back?

Cataracts cannot grow back, but sometimes a thin cloudy membrane grows behind the lens implant, making your vision blurry like the cataract did. This is not uncommon—it happens to roughly 10 percent of patients having cataract surgery.

If it happens to you, a quick and simple laser treatment can be performed to re-establish clear vision.

Contact our office at 413.363.2732 or fill out OUR CONTACT FORM to learn more about cataract eye surgery and implants in Massachusetts, and we’ll schedule an appointment to begin discussing and evaluating your options.

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