LASIK As A Solution To Cataract Complications

A clear, natural lens is a structure that is common in most eyes. This lens helps focus light on to the retina and allows for clear vision. If the lens is too strong then the eye is considered nearsighted(myopic), and conversely if it is too weak then it is considered farsighted(hyperopic). Another function of the natural lens is to absorb harmful ultra violet light that enters the eyes. This light can cause macular degeneration, and cancer in those individuals that are predisposed to those conditions. As a result of this UV light absorption, a chemical transformation occurs in the lens. The type of protein that makes up the lens, changes from an alpha type to a beta type. This alteration makes the lens appear yellow, and decreases the light transmission through the lens. This process is called cataratogenesis and results in a cataract.

When the natural lens reaches the point of cataract, that individual is unable to see clearly enough. If it interferes with daily functions, it must be removed surgically and most often is replaced with an implant. The basic concept is to improve the quality of the vision, and also reduce or eliminate the need for distance eye glasses in the process. This can be accomplished by calculating the correct implant power to focus light onto the retina. Fortunately, this is usually done when the surgery is performed by well qualified experienced surgeons.

There are factors that may complicate, and alter the final results of a lens implant. For example, in very farsighted patients the “A” factors which is critical in implant calculation may not be as accurate as would be liked, and the final implant power may significantly be off. Another issue effecting a successful lens implant, may be the implant moving forward, or back changing the effective power of the implant. In addition, if the cornea heals in such a way as to change the effective curvature, then the implant will likewise not focus light exactly on to the retina. In cases such as these, a refinement is necessary, and may consist of one of three options are available.

The first is to simply wear eye glasses. If that is not acceptable alte
ative, the second choice is to remove the implant and replace it. This requires an additional surgery and is most often met with patient resistance. This brings us to the third and most popular option, LASIK. LASIK is the reshaping of the cornea to focus light on to the retinal with out the need for eye glasses. A flap is created either with a microtome blade or by laser, called Intralase, and then the underlying tissue is altered with a laser. In doing so, the need for further distance correction can be reduced or eliminated. In addition, if astigmatism is only present, then radial incisions can be placed peripherally in the cornea perpendicular to the astigmatic power eliminating that as well.

This new procedure of post cataract refractive surgery fine tunes the surgeon’s ability to “get rid” of glasses after the surgery. Healing time is a few days, and the results are exciting. While additional surgery may not be desirable, it potentially can eliminate the need for eyeglasses or contact lenses.