Cataract Surgery

Understanding Cataracts

A cataract is a gradual clouding of the eye’s natural crystalline lens. The lens assists with focusing light rays onto the retina, which then communicates images to the brain. After the lens of the eye starts to cloud and harden, it is impossible to return the lens to its clear state with medications and may require cataract surgery. Various factors may cause cataracts including cigarette smoking and diabetes.  Other factors such as obesity, prolonged exposure to sunlight, and excess alcohol consumption have all been implicated by the National Eye Institute as having the potential to increase cataract formation.

A lens discoloration is universally seen in patients in their early fifty’s. They are not usually visually significant at an early stage. Most patients with early cataracts are unaware that they have them. Patients tend to adjust well for the vision changes that so gradually occur as the cataract advances. For most patients, symptoms of a cataract are vague but include decreased vision, double vision, glare, dullness of colors, and problems with night driving. Cataracts are a progressive condition that will eventually lead to diminished ability to perform activities of daily living. During your visit with Dr. Duzman, please mention any concerns that you have regarding your visual symptoms. Dr. Duzman will evaluate your cataract during each visit and advise you when he thinks that surgery is warranted.

Treatment for symptoms caused by cataracts depend on several factors. Most advancements in the field of cataract treatment in the past few years have been aimed at creating a custom plan for vision correction for each patient. During your appointment with Dr. Duzman, he will discuss with you how your visual symptoms affect your daily life. From that discussion, he may suggest a change in glasses prescription or cataract surgery.

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Cataract Surgery 

According to the American Academy of Ophthalmology, more than 3 million patients have cataract surgery, making it one of the more common and successful surgeries performed today.

Dr, Duzman uses the most advanced microsurgical techniques, including phacoemulsification. This procedure uses high frequency ultrasound waves to gently remove the cloudy lens from the eye. This is the simplest, safest, and most successful cataract treatment available today.

• During cataract surgery, the eye is first dilated with eye drops. IV medications are given to induce twilight sleep, however, the patient is still fully aware and in control of their actions. The eye is cleaned with betadine solution, and anesthesia is given in the form of eyedrops and and gel. A micro-incision is performed through which the ultrasonic phacoemulcification device is inserted. The lens of the eye sits in a capsule behind the pupil. Dr. Duzman opens the lens capsule with precision microsurgical instruments, gaining access to the lens material. The lens material is then gently aspirated from its capsule, and removed using the ultrasound tip. Finally, the lens chosen by Dr. Duzman specifically for you, is delivered into the eye using the small incision created. The lens is then centered in the capsular bag and will remain inside your eye, in this location, without moving and cannot be felt or sensed in any way. The incision is then checked for water tightness and a clear shield is placed on the eye.

Once surgery is done, you will spend approximately a half an hour in the recovery room and then be discharged to home.

After Cataract Surgery

Recovery from surgery is generally very quick, with most patients achieving noticeably better vision within the first 24 hours of the procedure. Patients are generally asked to use several eye drops after surgery for a period of 1 month. Your condition after surgery varies from person to person. Most people go home and relax, some sleep or rest the day of surgery. You may go for a light walk if you feel up to it. You should have virtually no pain after the procedure. Some patients do report a mild scratchy sensation after surgery that usually abates after a few hours. This is normal. Vision may be good or blurry in the first few days after surgery. The first two weeks after surgery are critical for a quick recovery.  Patients are asked to refrain from strenuous activity such as heavy exercise or any heavy lifting. Patients should also refrain from eye rubbing or swimming in a pool for 1 month post surgery. 

Customizing your cataract surgery experience

Once the cataract is removed, a clear artificial intraocular lens implant (IOL) will be placed in your eye. If your eye is healthy, you have a choice of several types of implants that can be placed. Depending on the refractive state of your eye, you may have an option of a monofical, multifocal or toric (astigmatism correcting) lens implant. Dr. Duzman will discuss these options with you in the pre-operative appointments.  The new premium IOL’s have advanced designs to give our patients the ability to see near and far with reduced dependence on glasses. Dr. Duzman realizes each patient has unique visual requirements and will customize the lens implant based on a comprehensive examination of your eyes.

Symfony Extended Depth of Focus Lens (EDOF).

This lens has been long awaited by American surgeons. It has been used in South America and Europe with great success for several years. In the early parts of 2016, this lens was approved by the US FDA. The platform on which this lens sits has been successfully used in the US for many years and has an excellent safety profile. The EDOF Symfony lens allows patients clear vision for everyday life. It enhances distance, intermediate, and near vision with significant reduction, and in some cases elimination of the use of glasses. The Symfony is a vast improvement over its predecessors as it provides some range in vison, is less dependent on lighting conditions and its geometry reduces the chance of halos sometimes experienced with this class of lenses. This lens can also treat astigmatism if present for even better visual outcomes. Dr. Duzman was one of the first surgeons in Orange County that has embraced this technology and has many happy patients that have benefited from this advanced lens.

Since its FDA its approval in 2016, this is Dr. Duzman’s preferred premium lens. Only with a thorough evaluation of your eye, will Dr. Duzman have the ability to custom fit a lens for you.

Toric lens

Most people have astigmatism as part of their prescription. Astigmatism refers to an uneven corneal surface that deviates from being spherical. It is oblong. If uncorrected with glasses, contacts, or at the time of cataract surgery, astigmatism results in distorted vision. Astigmatism can be corrected at the time of cataract surgery with either a laser procedure, for small amounts of astigmatism, or a Toric lens, for higher amounts of astigmatism. The Toric lens optically counteracts the mis-shaped corneal surface allowing restoration of clear vision. Toric lens placement, as with the EDOF lens, needs to be very precise. Dr. Duzman uses the latest in laser technology to achieve the highest possible precision for each patient.

Femtosecond Laser assisted Cataract Surgery (FLACS)

Most advancements in the field of cataract surgery in the past several years have been in customizing cataract surgery for patients. Laser cataract surgery has led the ability of Ophthalmologists to accurately implement these advancements. The laser images the patient’s eye, which allows Dr. Duzman to custom treat each patient’s particular eye. With the acquired images, the laser can accurately automate several steps in the cataract surgery. This automation makes these steps more predictable and more precise, setting the stage for improved visual outcomes of the cataract procedure. Patients now have a choice not only in lens design, but also, having surgery with manual instruments or with an increased precision of a laser.

Dr. Duzman uses the Catalys precision laser system and believes that utilizing this tool leads to more predictable and precise results of the cataract procedure. This allows our patients to achieve better, more predictable and clearer visual results.