Focus up, people! Today, let’s turn our gazes towards a common medical condition that, if left untreated, can lead to blindness.
Although more common in older people, anyone can develop dense, cloudy areas that form slowly in the lens of the eye called cataracts. According to the National Eye Institute, “By age 80, more than half of all Americans either have a cataract or have had cataract surgery.”
Cataracts are actually clumps of proteins that build upon the eye’s natural lens, distorting the image it sends to the eye’s retina, through the optic nerve, and to the brain for interpretation.
The Mayo Clinic says, “For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window.”
Cataracts make driving, reading, and “normal life” difficult. Corrective eyeglasses can help – up to the point of needing surgical removal of the optical obstruction.
Healthline describes one type of non-invasive cataract surgery:
“One surgical method, known as phacoemulsification, involves the use of ultrasound waves to break the lens apart and remove the pieces.”
More advanced cases call for invasive techniques like extracapsular surgery, where a long incision in the cornea allows removing the cloudy part of the lens. After surgery, the natural lens is replaced with an artificial intraocular lens (IOLs).
In my family, in the 1990s, my mother’s father needed surgeries to remove cataracts from each of his eyes. Unfortunately, both attempts to clear his vision failed. We observed his mood sour and his morale drop, as the reality of utter blindness – after a lifetime of having very good vision – settled in on him. He hated the loss of his independence, having to be led around the house, his domain.
In 2014, when I had my eyes checked for glaucoma (no worries in that department, thankfully), the ophthalmologist – eye doctor – switched the subject to cataract replacement surgery, which he also performed.
A placard in the waiting room described the then-new cataract replacement lenses available with 12 digital focal points. The doctor said that, in the future, lenses would be able to change their focal distance settings with much finer precision. He advised me not to consider Lasix, but to wait until I got older and needed cataract replacement lenses, at which time even better future tech would undoubtedly exist.
All About Vision explains how IOLs are revolutionizing cataract surgery:
“In the past, the primary goal of cataract surgery was to restore a person’s vision for driving, watching television, and other distance vision tasks. To see clearly up close, a person would need to wear bifocals or reading glasses after cataract removal to correct the inevitable post-surgical presbyopia [inability to see things clearly up close]. But today, cataract patients have the choice of multifocal IOLs that can correct vision far away, up close and all distances in between.”
Today, there are two main FDA-approved cataract surgery IOLs. One, from Alcon, has been used since 2005. It compensates for lighting conditions at three ranges: near, intermediate, and distant. Abbott Medical Optics rolled out their competitor product in 2009, which enhances image quality, regardless of distance, in any light levels, and for all pupil sizes.
Several scientific studies, including this one from Healio, the Journal of Refractive Surgery, have compared single-focus to multi-focus post-cataract artificial lenses. Their findings show mixed results:
“Monofocal and multifocal IOLs provided good clinical outcomes. More patients receiving multifocal IOLs attained better uncorrected visual acuity at a range of distances and spectacle independence compared with patients who received monofocal IOLs. Monofocal IOLs were associated with better patient-reported scores for glare compared with multifocal IOLs; however, scores for patient satisfaction were significantly better in the multifocal group.”
Time – and technology – wait for no one. It’s plain to see we can expect cataract lens replacement surgery techniques to continue improving.