Cataract surgery becomes faster, safer

October 23, 1990|By Gary Legwold

Some statistics are real eye-openers: Surgery to remove cataracts has increased threefold in the last 10 years and in recent years about 1.25 million cataract operations were performed in the United States annually.

At a glance, those numbers may appear alarming, but ophthalmologists and people who have had cataract surgery within the past few years have a different point of view.

The technological advances in cataract surgery are the main reasons for the impressive increase, says Hugh R. Taylor, M.D., an ophthalmologist at Johns Hopkins University in Baltimore.

These advances now mean fewer risks, faster recovery and better vision after the surgery. As a result, more people are having cataracts removed sooner.

"Ten years ago, you would not have had cataract surgery unless you were legally blind -- that is, less than 20/100 vision," says Taylor. "Now, some people have surgery when cataracts cause their vision to drop below 20/40, the minimum level required to pass the driver's license eye test."

The technology has changed but the basic surgery is the same. Cataract surgery removes the clouded lens of your eye so you can see clearly again.

With the method of surgery used 40 years ago, the lens and the capsule that holds the lens were completely removed.

But, stitches couldn't be used because they were not thin enough for use in the eye, so the incision had to heal by itself.

Patients often had to lie in dark rooms for six weeks with their head movements restricted by sandbags to ensure proper healing.

Two-week hospital stays were common 20 years ago, partly because of the high risk of developing an infection.

After surgery, patients had to wear glasses with thick lenses to help the lensless eye focus. Those glasses were cumbersome and often distorted vision.

Now, only the front of the lens capsule is removed. Leaving the back of the capsule reduces bleeding and the risk of a detached retina.

In recent years, some surgeons have switched to using ultrasound to break up the clouded lens. The pieces then are suctioned out through an incision less than half the length used in the old surgery.

The remaining portion of the capsule can hold an artificial replacement lens, according to Todd Zwickey M.D., an ophthalmologist in Minneapolis.

The new lens reduces a need for special cataract glasses so many people can wear regular bifocals after the surgery.

The risk of infection has been reduced by the use of improved antiseptic solutions. Fine nylon sutures close the incision, speeding recovery.

And surgery is often done on an outpatient basis. The result is a much brighter outlook: About 90 percent of patients have good vision in three to eight weeks after surgery, compared with three months for the old method of cataract surgery.

For more information on cataracts, send a stamped, self-addressed business-size envelope to the Inquiry Clerk in Department CT, at the American Academy of Ophthalmology, P.O. Box 7424, San Francisco, Calif. 94120.

(Gary Legwold is a health and fitness writer who lives in Minneapolis.)

(c) 1990 Meredith Corporation. Reprinted with permission from Mature Outlook. Distributed by the Los Angeles Times Syndicate

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