Cataract
Dr. Hunter has completed in-depth training in order to perform and offer the most advanced options during cataract surgery such as laser-assisted cataract surgery and glaucoma treatments, the new iStent and iStent Inject for his patients.
Innovative technology, with little to no downtime.
If you have cataracts, you may be experiencing problems such as blurred, distorted vision, glare from sunlight or headlights, or trouble focusing on certain objects. Colors may appear more dim or less vibrant. When these symptoms begin to affect your daily activities, you may want to consider state-of-the-art laser cataract surgery. Board-certified ophthalmologist, Dr. Drew Hunter continually applies innovative technology such as laser-assisted cataract surgery, interactive lens implants which can maximize your vision, and the Dropless cataract procedure to get the best outcomes for his patients. The new lens implant designs can correct astigmatism and even give you distance and near-vision with an extended range of vision and less dependence on glasses. The surgery is performed on an outpatient basis, and patients typically resume normal activity the very next day.
But what is a cataract?
It helps to understand a little bit about the anatomy of the eye in order to understand what cataracts are and how cataract surgery can help. First, there are two parts of the eye that help focus the outside world onto the back of the eye, or retina. Think of the retina like the film of a camera.
The first part of the eye that helps focus the outside world is the cornea, which is like the front windshield of the eye. The second part is the lens that is inside the eye. That lens is about the size and shape of an M&M piece of candy. When we are born, that “M&M” is crystal clear, and is also what changes shape to help our focus go from distant to near. Over time, as we are blessed to have birthdays, the “chocolate center” part of that “M&M” becomes stiff, can’t change shape as well, and we start to lose our ability to focus at near distances (for someone who never needed glasses or contacts) and by age 40-45 we may find ourselves needing reading glasses. As time passes, the “chocolate center” part also becomes cloudy and that’s what we call a cataract.
What is Cataract Surgery?
Cataract surgery is basically when the doctor opens the shell of the “M&M”, cleans out the cloudy center part and replaces it with a new, man-made lens. You will hear people talk about a lot of different options available during cataract surgery, but no option is perfect and it is very important to only consider what is safe for you, has a good chance of getting you to the vision that you want, and can be expected to last a long time. Prior to any surgery, all of my patients undergo extensive testing to make sure any options considered, are good options for them. People love to hear about advanced laser-assisted cataract surgery, full range of vision lenses, and Dropless cataract surgery; however, it’s important for patients to know the limitations, risks, and benefits of each option so they can be empowered to make the best choice for themselves.
What is Laser Cataract Surgery?
When it comes to having surgery on your eyes, you want the best technology and training. Fortunately, for cataract surgery patients in the Bluffton, Hilton Head, and Beaufort areas, Dr. Hunter uses the most advanced femtosecond laser on the market, LENSAR, to assist with cataract surgery. The LENSAR system maps out the cornea, iris, and cataract for each patient to create a 3D model of their lens and tailor the treatment specific for their eye. It helps create all of the incisions, softens the cloudy “chocolate center part of the M&M”, and helps reduce astigmatism to give sharper vision after surgery. This is in place of the traditional method that requires a blade. Unfortunately, because the LENSAR system minimizes astigmatism, which gives us sharper vision, there is a portion of this option that insurance does not cover.
We help you choose the right lens implant.
Once you’ve made the decision to undergo cataract surgery, we will spend time discussing the different lens options that best suit your needs. Even though there is spectacular technology available today that can help you gain your best vision, no lens is perfect. Dr. Hunter will do extensive testing to determine which lens options are good for you to even consider. After determining what options are safe for your eyes, have a good chance of getting you to the vision you want it to be and can be expected to last a long time, he will go over the pros and cons of each option.
The Traditional lens is a monofocal lens implant, which enables for vision of one distance, typically for distances far away, and often leaves the patients with glasses full-time especially if they have any astigmatism. However, you can now choose from newer, more advanced lenses that can minimize larger amounts of astigmatism and give a fuller range of vision, thus further minimizing the dependence on glasses after cataract surgery. If you have very mild or no astigmatism, you may find that the distance vision with this lens is very good without any glasses. With larger amounts of astigmatism you will need glasses to correct all distances.
Toric lenses are astigmatism-correcting, monofocal lens implants. These lenses have a single focal point similar to the “Traditional monofocal lens”, but are designed to correct pre-existing astigmatisms, in order to provide great distance vision without glasses. Glasses would still be needed for near-vision activities, such as reading.
Multifocal or Extended Depth of Vision lenses, like the Panoptix or Symfony lens, are some of the most advance lenses available today. This advanced technology can minimize larger amounts of astigmatism and has multiple focal points, designed to provide a full range of vision: near, intermediate, and distance vision. These lenses also offer enhanced image quality at all distances.
DROPLESS CATARACT SURGERY
Basically, there are three different medicines we need after cataract surgery: an antibiotic to prevent infection, a mild steroid to help healing, and a non-steroid anti-inflammatory that helps prevent swelling in the retina after the procedure. Dropless cataract surgery is the option to have these medications placed in the back of the eye during surgery instead of using them as drops on the surface.
Patients love the idea of Dropless cataract surgery because it is less of a burden than using multiple eye drops after surgery, and the dropless option is oftentimes less expensive than the drops from the pharmacy. So why not do it for everyone? Dr. Hunter has been performing Dropless cataract surgery for over 4 years and offers it as an option to his patients. However, after discussing all of the risks and benefits of the Dropless procedure, few patients actually choose that option.
Is Dropless cataract surgery SAFE?
Just like any medicine we place in the body, some people have a poor reaction to it, which could even lead to blindness. If we place the medicine in the back of the eye and you have a poor reaction from the Dropless procedure, we cannot remove it. However, if we are using the drops on the surface of the eye and you have a poor reaction, we can stop them.
Why do you still offer Dropless Cataract Surgery?
Some patients feel like the risk is worth it to not have to use the drops afterwards. We also have some patients where the benefit outweighs the risk. For instance, if a patient has dementia and can’t remember to take their drops, or Parkinson’s where it is more difficult to get drops in because of hand tremors. It’s important that patients know the options, and the risks and benefits of those options, so they can make the best decision for them.
The surgery process:
After anesthesia and the numbing of the eye, your cataract surgeon will be ready to start the procedure. First, they will create a very small incision in the cornea and insert a tiny high-frequency ultrasound probing device to break down the cataract. The cloudy cataract is broken down and removed from the eye; this process is called phacoemulsification.
The artificial lens implant (IOL) is then inserted through a tube and unfolds once in place. IOLs will have haptic and “lens arms” to hold them in place. With the cataract removed and the IOL in place, light can once again travel unimpeded to the back of the eye and focus on the retina where the image is interpreted and transmitted to the brain. The end result is clear, youthful vision.
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