About Custom Cataract Surgery
Serving Patients in the San Jose and East Bay
Why cataract surgery with the surgeons at OPTIMA is the best first step…
Imagine life without glasses or contacts, everything in clear, bright, vibrant color. Activities like driving, reading, hiking, biking, swimming and golf are much more convenient. At OPTIMA, this freedom and comfort is precisely what we strive to achieve every day for the people who have chosen to trust their eyes to us.
The center you choose for vision correction should offer advanced technology and experienced eye surgeons. Our surgeons hold leadership roles in the development of new vision correction technology giving them early access to the latest advances. Our patients often benefit from next-generation technology before it’s available anywhere else.
The latest technology is important and it can affect your level of satisfaction with the procedure. However, it’s the surgeon and dedicated the staff behind the technology that truly makes the difference. The surgeons and surgical team at OPTIMA have been recognized as leaders in the field, and are continually setting the standard of care that other eye surgeons follow.
As you consider any type of vision correction, you can be confident in our commitment to be there every step of the way to make the process comfortable, and above all, successful.
To download our brochure on cataract surgery, click here.
What is a cataract?
A cataract is a clouding or opacification of the naturally clear lens inside the eye. This clouding causes blurred or foggy vision or glare. It is not a visible film or growth over the outside of the eye. The word “cataract” actually means “waterfall” – as if one were looking through a waterfall.
There are two basic types of cataracts
The slower growing “nuclear” type in which the entire lens turns yellow-brown, and the faster growing “subcapsular” type which affects younger people, those with diabetes, and patients taking cortisone.
How do I know if I have a cataract?
You will probably notice a decrease in vision and/or glare and halos around lights. You may be unable to see clearly to perform the tasks that you need or want to do. Changes in your eyeglass prescription will no longer improve your vision.
A thorough eye examination by your optometrist and our surgeons can detect the presence of a cataract, as well as other conditions that also may be causing altered vision.
Other reasons for visual loss in addition to the cataract may involve problems with the cornea, the retina, the blood vessels in the back of the eye, or the optic nerve. If these other conditions are present in addition to the cataract, you will likely experience an improvement in vision, but not perfect vision following cataract surgery.
We will explain to you and your family the details of your situation after a thorough exam.
How is a cataract treated?
Surgery is the only way that a cataract can be treated. There are no pills or drops, vitamins, exercises, or lenses that have been shown to prevent or cure cataracts. However, if symptoms from a cataract are mild, a change of glasses may be all that is necessary for you to function more comfortably as the cataract progresses.
Protection from excessive sunlight may help prevent or slow the progression of cataracts. Sunglasses that screen out ultraviolet (UV) light rays or regular eyeglasses with a clear, anti-UV coating offer this protection.
If surgery is required, it is comforting to know that cataract surgery is safe and extremely effective in restoring vision. In fact, cataract surgery has one of the highest success rates of any surgery.
About 2 million people a year have cataract surgery in the United States. Our surgeons are among the most experienced in the country.
What can I expect from surgery?
At OPTIMA, cataract surgery is performed under local anesthesia at our federally-certified ambulatory surgery center located within our office. Our center was the first outpatient surgery center in the United States to be certified by Medicare and has been in continuous operation since 1981. Because our center specializes only in eye surgery, our highly trained staff is dedicated to ensuring the highest level of care. We use only state-of-the-art equipment in our warm and comfortable environment.
Before surgery we communicate with and obtain medical clearance from your primary care physician. During surgery you will be awake, but relaxed. Our anesthesiologist will be at your side.
We perform this intricate surgery using a microscope, micro-surgical instruments, and, if the patient chooses, the LenSx femtosecond laser. We were the first site in California to utilize the Alcon Centurion Cataract System which employs the latest technology using radar waves through a small incision to remove your cataract.
The focusing power of your eye is restored by replacing the cataract with a permanent intraocular lens implant. We often use multifocal implants that allow both distance and near, or distance and intermediate vision if the patient desires. If one has astigmatism, we can use an astigmatism (toric) implant and/or the LenSx laser to decrease the astigmatism. In most cases, sutures are not needed.
Due to advances in medical technology, we now have a number of choices for the type of advanced lens implants which will be placed in the eye. The physicians and staff at OPTIMA are here to help you make the choice, but ultimately, the choice of which implant to use is up to the patient and the family.
It’s here! … Laser-Assisted Cataract Surgery
Until now, standard cataract procedures were performed manually where the surgeon used a blade for all of the incisions and other portions of the procedure. A manual procedure allows for a margin of error that can affect outcomes. Recent innovations have led to the development of laser-assisted cataract surgery. The LenSx femtosecond cataract laser offers the precision of bladeless laser technology allowing the doctors at Optima to plan, customize, and perform your surgery to exacting, individualized specifications. Laser-assisted cataract surgery combined with advanced lens implant options are providing our patients with an improved lifestyle with more freedom using the latest technology.
Benefits of LenSx Technology
- No metal blades
- Enhanced precision
- Astigmatism control
- Faster recovery time
Cataract Lens Implant Choices
- Both eyes adjusted for distance vision
If the power of the intraocular lens for both eyes is adjusted for distance vision, patients generally will need glasses for some distance functions as well as for reading and intermediate tasks such as the computer, dashboard, cell phone, and wristwatch. With this option, glasses will be required most of the time at most distances.
- One eye adjusted for distance and the other eye adjusted for near (blended vision)
By using different implant powers for each eye, we can adjust the vision in one eye for the distance and in the other eye for near tasks such as reading. For this option, we use either the Staar Nanoflex lens, or if the patient has astigmatism, the Alcon Toric implant. With blended vision, patients can be glasses-free much of time.
- For patients with high amounts of astigmatism
Astigmatism is when the eye is shaped more like a football than a basketball. There is a lens implant option called the “toric” IOL. This lens has the astigmatism ground into the implant (like your glasses). The advantage to this lens upgrade is that, because it significantly reduces or eliminates the astigmatism, people are often glasses-free or much less dependent upon glasses following surgery for the distance. However, unless we do monovision or blended vision with the toric lens, glasses will be required for computer and reading.
- Multifocal/Bifocal implants
For many years, we have been using multifocal implant lenses. Dr. Mandel was one of the first surgeons in Northern California to implant the multifocal lens. With this option, each eye receives a multifocal lens. When looking at a distant object, patients can see well in the distance. Also, patients can see well when viewing intermediate targets such as the dashboard, a cell phone, a computer, or a wristwatch. Often, near targets such as menus and the newspaper can also be seen more clearly than with the standard lens implant. By far, this is the best option for patients who wish to have as “natural” vision as possible at all distances. Although we strive for glasses-free vision, these lenses and the healing of the human eye are never perfect and occasionally the use of glasses or corrective surgery may be necessary to “fine tune” the vision for certain distances following the implantation of a multifocal implant.
After your surgery
After cataract surgery, you may return almost immediately to all but the most strenuous activities. We will provide you with written instructions and a helpful guide for the use of eye drops following your surgery. Several post-operative visits are needed to check on the progress of the eye as it heals.
Cataract surgery is a highly successful procedure. However, it is important to understand that complications can occur during or after the surgery, some severe enough to limit or lose vision. Fortunately, in our hands, improved vision is the result in over 99% of cases unless there is a pre-existing problem with the cornea, retina, or optic nerve. In approximately 15% of people having cataract surgery, the natural capsule that supports the intraocular lens will become cloudy within 6 to 24 months following surgery. In these cases when part of the cataract “grows back,” the YAG laser is used to painlessly open this cloudy capsule, restoring the clear vision. This is performed as an outpatient procedure at our office.
Cost of cataract surgery
Medicare and insurance companies pay for the removal of the cataract and the standard distance implant. However, they do not pay for the upgrade for the premium implants or for the LenSx laser procedure.
Cataracts are a common cause of poor vision, but they are treatable. Our experienced surgeons can tell you whether a cataract or some other problem is the cause for vision loss, and help you decide if cataract surgery is appropriate for you. Additionally, we will help you choose the lens implant that best suits your lifestyle. If you elect to undergo surgery, you have an extremely high chance of experiencing greatly improved vision.
To learn more about cataract surgery, including whether you may be a candidate for traditional or laser-assisted cataract surgery, contact our practice today to set up a consultation. Call 877-210-2020 today!