Cataract patients get a glimpse of the future

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July 26, 2009

By RANDY GRIFFITH The Tribune-Democrat Sun Jul 26, 2009, 10:56 PM EDT

For those losing vision as they get older, cataract surgery long has been a godsend.

Now, experts say technology has made it even better for many patients.

A new generation of artificial implanted lenses has created new options, eliminating the need for glasses after cataract surgery, Johnstown Drs. Joel Bezek and Joseph Polito said.

“The lenses are better now,” Bezek said at Ophthalmic Associates, 1318 Eisenhower Blvd. “For 90 percent of our patients, they can be glasses-free.”

A cataract is the clouding of the eye’s natural lens or the surrounding tissue, Bezek said. As severity increases with age, more light is obstructed as the clear lens becomes more opaque.

“Cataract surgery takes the opaque window out and puts a clear window in,” Bezek said.

The basic procedure of replacing the cataract-clouded lens with a manmade implant has been around since the 1940s, Polito said. There have been advances, but the current technology was about 20 years old.

That technology involved monofocal lenses, which was usually designed to focus the eye for distance vision. That meant virtually all patients required reading glasses for close focusing, although some patients reduced their need for glasses by having one eye’s implant focused for distance and the other for near.

New advances have introduced multifocal implants and accommodating implants that provide both near and far vision, Bezek said. Multifocal lenses have different surfaces for each distance, much like a progressive bifocal in glasses. Accommodating lenses flex with the eye like the natural lens.

“It’s similar in cost to Lasik surgery in younger people,” Bezek said. “The advantage is you can see near and far, and we remove the cataracts.”

So why wouldn’t every cataract patient want the glasses-free option?

It’s not covered by Medicare or many other insurance policies, Polito said, so it costs about $2,000 to $3,000 more out-of-pocket.

“It is a whole different program,” Bezek said. “A patient has to make a choice.”

Because the option is new and not widely publicized, some patients have been confused, he said.

“This is a lens for people who want to reduce or eliminate glasses,” Bezek said.

The surgery itself is the same as it has been for about 30 years.

The minimally invasive procedure uses an ultrasound device to break up the damaged lens so it can be removed through a tiny incision, Polito said. Usually the incision is about one-tenth of an inch.

“Before, they went in and got the cataract out manually,” Bezek said. “The old way, half the eye was opened. Surgery took longer to heal.”

Cataract surgery takes about 10 to 15 minutes and uses only local anesthesia, so the patient remains awake throughout. Full recovery can be expected in a few weeks.

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