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Refractive Cataract Surgery

What are Cataracts?

Studies show that in the United States, more than 24 million people aged 40 and over are impacted by cataracts. Cataracts occur when the natural lens inside the eye (affected by age or injury) becomes thickened, less transparent, and more rigid. These lens changes will decrease the clarity of your vision. Cataracts progressively worsen over time and can ultimately cause blindness.

What is Refractive Cataract Surgery?

This procedure is similar to traditional cataract surgery, where the natural cataract lens is removed from the eye and replaced with an Intraocular lens implant, but the difference is that refractive cataract surgery uses advanced laser and lens technology to eliminate your prescription at the time of surgery. Refractive cataract surgery can correct nearsightedness, farsightedness, and astigmatism. With this procedure, you can dramatically reduce or eliminate your dependence on glasses or contacts for far and near vision.

LensX Laser Cataract Surgery

While traditional cataract surgery involves a surgical blade to perform the various incisions through the cornea and inside the eye, the LenSx® femtosecond laser allows us to perform a “bladeless” surgery. The use of the LenSx® femtosecond laser improves the precision and reproducibility of the incisions made during cataract surgery which ultimately improves healing times and outcomes for Dr Salisbury’s patients.

The LenSx® femtosecond laser produces a beam of laser light to create the incisions for cataract surgery. Dr. Salisbury controls an advanced computer-guidance system to direct the laser over the eye to provide the most precise and accurate results for each patient. The LenSx® femtosecond laser is also used to reduce and eliminate astigmatism. Once the cataract is removed, Dr. Salisbury uses a refractive lens implant inside the eye to improve your vision. Electing to use the LenSx® femtosecond laser during your cataract surgery will result in clear distance vision, allowing you to eliminate the need for prescription glasses.

Multi-Focal IOLs

Multifocal IOLs are the most technologically advanced intraocular lens implant used in cataract surgery. Patients who are candidates can elect to have this type of intraocular lens implant placed during refractive cataract surgery or refractive lens exchange surgery. These types of lenses will provide clear distance, intermediate, and reading vision without having to wear any type of glasses or contacts afterwards.

Patients who are active and are motivated to eliminate their dependence on bifocal, progressive, or reading glasses are great candidates for a multifocal intraocular lens implant. These implants can be placed at the time of cataract surgery or prior to the development of cataracts with a refractive lens exchange surgery. A multifocal intraocular lens has concentric rings etched onto the surface of the lens implant which allows images at a variety of distances to focus on the retina.

Basic cataract surgery replaces the cataract with a single-focus lens implant which means that glasses will at least be required for computer use and any near vision activity. Multifocal lens implants provide clear vision at all ranges and eliminates the need to wear glasses for all activities including computer, cell phone, and reading various sizes of print.

Astigmatism Correction

Astigmatism is defined as a blurring of vision due to an irregular shape in the cornea or lens. Eyes without astigmatism typically have a cornea and lens with similar curvature in all directions. This allows light to be focused to a single point on the retina.

Patients with astigmatism have more curvature in one direction, or meridian, compared to the meridian in the opposite direction. This prevents light from being focused to a single point on the retina which results in blurry vision at all distances. A normal eye has a round cornea shaped like a basketball. An eye with astigmatism has a cornea shaped like a football. In most cases, patients are born with this condition but there are other pathologic and progressive causes of astigmatism, such as keratoconus, corneal lesions, scars, and previous cornea surgery.

Astigmatism is very common and can be measured during a routine eye exam. A refraction is the simplest way to measure the amount of astigmatism that is present in an eye but there are other advanced technologies that can be used to measure astigmatism. Dr Salisbury uses these technologies during any surgical consultation for vision correction.

Astigmatism can affect patients differently. Those with mild astigmatism may not notice significant blurring but moderate to severe amounts of astigmatism can cause significantly blurry vision. The most common treatments for astigmatism are glasses, contacts, refractive surgery (LASIK, PRK, or ICL), and lens-based surgery (refractive cataract and RLE).

If you are interested in having a vision-correcting procedure, then we will want to address any astigmatism that is present in your eyes. Any patient who is undergoing cataract surgery may benefit from selecting an intraocular lens implant called a toric lens to correct larger amounts of astigmatism or electing to use the LenSx® femtosecond laser to create limbal relaxing incisions to correct lower amounts of astigmatism.

Dr. Salisbury will conduct a full evaluation and help determine which procedure is right for you.


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