Q. Is surgery the only option to treat a cataract?

A. Yes, surgery is the only effective treatment for cataracts but just because you have a cataract does not mean that you have to have it removed. Cataract surgery is indicated if you are not happy with your vision and want to see well. Talk to your doctor if you have any questions or concerns about your vision.

Q. Does cataract surgery hurt?

A. Thanks to numbing drops and medications to help you relax, this procedure involves minimal discomfort.

Q. Will I be asleep during cataract surgery?

A. Since this procedure does not take very long, it is unnecessary to put you completely asleep with general anesthesia. Instead, your surgeon will use a local/topical anesthetic to numb your eye and you will remain awake during the surgery.

Q. Who performs the procedure, a surgeon or a technician?

A. A surgeon will perform the procedure. There will be a technician and nurse in the room to assist them.

Q. I have cataracts in both eyes. Will the doctor treat both at the same time?

A. Typically, doctors will perform surgery in the second eye two or three weeks after the first eye. All patients are different, so talk to your doctor about what is right for you.

Q. How long will I be in the Surgery Center?

A. Patients commonly spend only a few hours at the surgery center, and are allowed to go home the very same day.

Q. How long before I can see after surgery?

A. Every patient and every eye is different, but patients commonly see well enough to drive the day after surgery. The presence of other eye diseases (glaucoma, macular degeneration, diabetes, etc.) may impact your recovery time. Ask your doctor how quickly he or she expects you to recover.

Q. How long until I can return to normal activities?

A. Most patients can resume normal basic activities like reading and watching TV by the next day, and return to work within two to seven days. Doctors typically recommend against any strenuous activity for two or more weeks. However, results vary for different patients, so you should ask your doctor what is best for you.

Q. After surgery, will I be able to drive at night?

A. Your ability to drive at night should be much enhanced once your cataract is removed. Patients with Premium Lens Implants, ReSTOR® or ReZoom™ IOL, may notice a ring of light around headlights and other point-light sources. These are typically mild, rarely bothersome, and tend to diminish with time.

Q. Will I need glasses after cataract surgery?

A. It depends on what type of intraocular lens you elect to have implanted. Most patients do not need glasses or contacts for distance tasks following cataract surgery with a traditional monofocal IOL but still rely on reading glasses for near tasks. However, in the clinical trials over 90% of Lifestyle Lens Implant patients reported never or only occasionally wearing glasses for distance, intermediate or near tasks after their surgery.

Q. Can my cataract come back?

A. No, once a cataract has been removed it cannot return. However, over time, patients may complain that their vision has once again become cloudy. This sometimes-common condition, which may occur with any type of IOL, is known as a secondary cataract or "PCO." Secondary cataracts can be easily treated by a simple laser procedure performed in the office.

Q. Are there any side effects? Anything I won't like?

A. There is a chance that you will experience halos or glare in your vision, but this is uncommon and usually goes away in time. Your intermediate (in-between) vision may not be as crisp as your near and distance vision, but over 90% of Lifestyle Lens Implant patients in the clinical study reported never or only occasionally needing glasses following cataract surgery in both eyes. As with any surgical procedure, there are risks. You and your doctor should consider the potential risks and benefits, and determine if the Lifestyle Implant is right for you.

Q. Can the lens be replaced if it doesn't work?

A. Although this would be unlikely, the IOL can be replaced with a different one if needed. Ask your surgeon how they would handle this situation.

Q. Any precautions after surgery?

A. Every patient is different, so be sure to ask your doctor for advice on caring for your eye after the procedure. Your doctor may ask you to refrain from rubbing your eye or engaging in any strenuous activity for a few weeks after surgery.

Q. Who do I call if I have a problem?

A. Consult your doctor immediately if you have any problems, especially if you experience decreased vision or pain.

Q. How long does my Cataract surgery take?

A. The actual surgery usually takes about ten minutes, but the overall experience takes approximately 2 hours - this includes your preoperative preparation, the surgery itself, and your post-operative care.

Q. How do I take my drops?

A. Before the surgery, the surgical schedulers will give you information about your drops. The day of surgery, the nurses at our surgery center will also give you that information. If there are any questions about your medication at a later time, please call our medical records department - they will take the information, pull your chart, and have a technician return your call.

Q. Will I still need to wear glasses if my surgeon recommends the AcrySof® ReSTOR® or the ReZoom™ Multifocal Lens?

A. The results will vary depending upon your vision, lifestyle and the anatomy of your eyes. Most people find that they need glasses to read very small type. Most people, however, can go to the store or conduct many of their day's activities without depending on glasses. In a clinical study, 92% of those who received the technology in AcrySof® ReSTOR® or the ReZoom™ Multifocal Lenses "never" or only "occasionally" needed to wear glasses.

Q. How are the AcrySof® ReSTOR® and ReZoom™ Multifocal Lenses different from traditional monofocal intraocular lenses?

A. The AcrySof® ReSTOR® and the ReZoom™ Lens is both multifocal intraocular lens. Unlike traditional monofocal (single-vision) lens implants, the ReZoom™ Multifocal Lens provides quality vision at all distances - near (reading), intermediate (computer use or cooking), and far (driving). Traditional monofocal lenses usually provide good vision only at a distance with limited ability to see objects that are near without glasses.

Q. How do the AcrySof® ReSTOR® and ReZoom™ Multifocal Lenses replace the cataract?

A. The natural lens inside the eye is gently removed through a tiny incision in the periphery of your eye's cornea. The cataract-impaired lens is then removed through this incision and the lens implant is inserted in its place to permanently replace it. The procedure usually takes about 10-15 minutes and vision is usually improved immediately.

Q. What if my medical history or current medication prevents me from considering an injection of local anesthesia?

A. Today, anesthesia may also be administered topically. This means no injection is required, and the medication numbs the eye without entering the bloodstream. Your physician can tell you if this is an appropriate option for you.

Q. How long after surgery until I see my best?

A. Like most procedures, this depends upon the overall health of your eye. For most people, vision is noticeably better immediately and continues to improve during the first few weeks after the procedure.

Q. Do the AcrySof® ReSTOR® and ReZoom™ Multifocal Lenses require an adjustment period?

A. Yes. For most people there is a period of weeks when your brain is learning to "see" up close and at a distance with the new lens. This adjustment period is usually complete within 6 to 12 weeks. Also, like all multifocal lenses, some people report halos or glare around lights. Again, for most people this diminishes over time. For some, it becomes less troublesome but never completely goes away. Most people report that the ability to see near, intermediate and far outweighs any visual side effects associated with the lens.

Q. Are there any risks of having the AcrySof® ReSTOR® or ReZoom™ Multifocal Lens procedure?

A. As with any surgical procedure there are risks. The biggest risk with any cataract procedure is infection. Less than 1 in 1,000 patients having a lens implant procedure ever get an infection and most are treated successfully with medications. Infections, however, can cause a severe or total loss of vision.

Q. Is there a congenital type of cataract?

A. Yes and we have to know why it is dangerous

Mortality/Morbidity:

· Visual morbidity may result from deprivation amblyopia, refractive amblyopia, glaucoma (as many as 10% post surgical removal), and retinal detachment.

· Metabolic and systemic diseases are found in as many as 60% of bilateral cataracts.

· Mental retardation, deafness, kidney disease, heart disease, and other systemic involvement may be part of the presentation.

Age: Congenital cataracts usually are diagnosed in newborns.

History:

· Congenital cataracts are present at birth but may not be identified until later in life.

· Some cataracts are static, but some are progressive. This explains why not all congenital cataracts are identified at birth.

· Anterior polar cataract and nuclear cataract are usually static, although they may rarely progress.

· Cataracts that typically progress include posterior lenticonus, persistent hyperplastic primary vitreous, lamellar, sutural, and anterior or posterior subcapsular. They usually have a better prognosis because they only usually begin to obstruct the vision after the critical period of visual development has passed.

· Not all cataracts are visually significant. If a lenticular opacity is in the visual axis, it usually is considered visually significant and requires removal.

· Cataracts in the center of the visual axis that are greater than 3 mm in diameter are generally considered visually significant. This principle is furthermore correlated with the clinical ophthalmological examination of the patient.

· In 2005, a study by the Department of Pediatric Ophthalmology of the Wills Eye Hospital concluded that, in terms of the risk factor for amblyopia, more important than the cataract size is the anisometropia induced by the congenital anterior lens opacities (CALOs). Patients with CALOs who have anisometropia of 1 diopter (D) or more are 6.5 times more likely to develop amblyopia.

Causes:

· The most common etiology includes intrauterine infections, metabolic disorders, and genetically transmitted syndromes. One third of pediatric cataracts are sporadic; they are not associated with any systemic or ocular diseases. However, they may be spontaneous mutations and may lead to cataract formation in the patient's offspring. As many as 23% of congenital cataracts are familial. The most frequent mode of transmission is autosomal dominant with complete penetrance. This type of cataract may appear as a total cataract, polar cataract, lamellar cataract, or nuclear opacity. All close family members should be examined.

· Infectious causes of cataracts include rubella (the most common), rubeola, chicken pox, cytomegalovirus, herpes simplex, herpes zoster, poliomyelitis, influenza, Epstein-Barr virus, syphilis, and toxoplasmosis.

· Retinoblastoma