Stockton Cataract Surgery: Saving and Restoring Vision

Stockton Cataract Surgery – Cataracts are one of the leading causes of vision loss in the United States, especially among older patients. These milky clouds in the eye’s lens are strongly linked to age, but they do occasionally occur in younger patients. Cataracts may appear in one or both eyes. As a part of our focus on senior eye care and disease management, Dr. Kenneth Miselis and the staff at Heritage Eye, Skin & Laser Center offer expert care for patients affected by cataracts in and around Stockton, Modesto, and Sacramento. Cataract surgery is a safe, effective procedure that can restore the personal independence that clear, crisp vision allows.

About Cataracts

A cataract is a milky clouding in the eye’s lens that develops gradually as proteins in the lens break down. Over time, this clouding begins to obscure the patients vision, eventually causing vision loss and blindness without cataract surgery. Symptoms include decreasing vision with age, blurred vision, frequent prescription changes, poor depth perception, problems distinguishing between colors, and difficulty seeing at night or in bright sunlight.

About Cataract Surgery

Cataract surgery is currently the only effective treatment for cataracts. Once the cataract has developed sufficiently, our Dr. Miselis can remove the obstruction by surgically extracting the lens from the eye.

Heritage Eye, Skin & Laser Center uses the best technology available in every phase of cataract surgery in order to help our patients see more clearly. First, we use the Alcon Series 2000® Legacy® phacoemulsifier to break up the lens for easy extraction. We rely on Alcon’s Infiniti™ Vision System to remove the lens, which makes possible a cataract surgery that is tailored to the patient’s eye, removing the lens safely through the smallest possible incision. We use the Zeiss IOL Master® to measure the eye precisely for its replacement lens.

Cataract surgery can be performed under local anesthesia with just a single small incision. Most of our patients from the Stockton, Sacramento, and Modesto areas are able to return home the day of cataract surgery.

Risk Factors For Cataracts

There are a number of risk factors for cataract formation, including exposure to ultraviolet (UV) light or radiation, hereditary and genetic factors, eye injuries, long-term oral steroid use, and medical conditions such as diabetes. Cataracts occur most often in older patients, though they occasionally occur in children as well. In fact, the large majority of eye care patients over 75 years of age are affected to some degree by cataracts.

Intraocular Lenses for Cataracts

After the eye’s natural lens is removed, cataract surgery patients receive an intraocular lens (IOL) implant to replace it. Premium IOLs incorporate multifocal technology, allowing patients to see clearly at multiple focal depths as they could with a healthy natural lens. We believe strongly in taking advantage of advanced vision care technology, and the state-of-the-art IOLs available at Heritage Eye, Skin & Laser Center are so effective that many of our patients experience significantly enhanced vision after recovering from cataract surgery.

Conventional Versus Laser-Assisted Cataract Surgery

There are two types of cataract surgeries:  conventional and laser-assisted cataract surgery.  The following is a description of both types of procedures.

Conventional Cataract Surgery

Conventional cataract surgery is performed by Dr. Miselis by hand without the assistance of a laser during the surgery. Dr. Miselis decides where he will place the incision, how deep and at what angle. He then creates a small incision by hand in the side of the cornea. Next, he manually creates an opening in the capsular bag using a hand-held instrument. He breaks up the cataract by hand (this process is called lens fragmentation) and removes it with a device through a process called phacoemulsification.  Next, he inserts and implants an artificial intraocular lens to replace the cloudy lens. Typically, the incision is self-sealing and, in most instances, does not require stitches.

Laser-Assisted Cataract Surgery

Laser-assisted cataract surgery is performed by Dr. Miselis with the assistance of a laser during part of the surgery.  A camera/ultrasound imaging device is placed over the eye to map its surface and gather information about the lens. Dr. Miselis is able to view the eye through a 3-D image and create a customized surgical plan. Dr. Miselis programs the laser with his customized treatment plan and then directs the laser over the eye to create a precise incision within a specific location, depth and length in all directions in the side of the cornea. Therefore, the laser makes the initial incision. This technique allows the procedure to be more accurate and reproducible.  It addition, it potentially increases the likelihood that the incision will be self-sealing at the end of the surgery, which reduces the risk of infection.

Next, the laser creates the opening in the capsular bag which may result in better centering of the lens (positioning of the lens is a significant factor in determining final visual outcomes).  The laser then breaks up the lens into smaller, softer pieces (lens fragmentation), requiring less energy to remove the cataract and allowing it to be removed quicker and easier. Using the laser for the lens fragmentation results in a 43% reduction in phacoemulsification power and up to 51% decrease in phacoemulsification time. This process provides increased safety for the eye and reduces the chance of certain complications.

Dr. Miselis then removes the cataract through a process called phacoemulsification.  Afterwards, he implants an artificial intraocular lens to replace the cloudy lens (the cataract). Typically, the incision is self-sealing and, in most instances, does not require stitches.

Lastly, the laser is also used to create incisions (called limbal relaxing incisions or LRI) which offset the curvature of the cornea, thereby reducing the amount of astigmatism.

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