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Understanding Cataracts

Everyone, if they live long enough, will develop cataracts. It is a natural part of the aging process. Light coming into your eye gets focused first by the cornea (front clear layer of eye) then by the lens onto the retina (the back of the eye). With time, the crystalline lens inside your eye hardens and eventually becomes hazy and more opaque. This cloudiness blurs your vision and is classified as a cataract. When the vision loss in quality and sharpness progresses to a point that your everyday activities are affected, cataract surgery is the next step. Read more...

In cataract surgery, your natural clouded lens is replaced with a clear lens composed of specialized polymers, which is known as an Intraocular Lens Implant (IOL).

There are three components to the cataract procedure that you need to understand:

  1. The pre-operative and diagnostic testing,
  2. The type of IOL that will be implanted, and
  3. The surgical procedure itself and the cataract removal technique.

Pre-operative Testing

There are standard techniques, which are used to measure the length of your eye by ultrasound and the curvature of your cornea and then a calculation is performed to determine the power of lens that is needed for your procedure. At Crystal Clear Vision(and other state of the art Cataract facilities), more sophisticated measurements are performed with a variety of specialized ophthalmic devices. Some of these devices can not only measure the central curve of your cornea, but across the entire cornea, and others can measure your astigmatism not only in your cornea but your lens to determine how much astigmatism is from the cataract which will be removed and how much will be left in your cornea and needs to be treated. There are even measurements that are taken that help us to center and align certain Intraocular Lens Implants (IOL) for the best astigmatism correction. The measurements for your eye length and calculations are determined by the IOL Master, a device, which has revolutionized the selection of the right Intraocular Lens Implant power and provides more accurate measurements for your IOL. Hide...

Intraocular Lens Implant Options

The pre-operative testing not only determines the right power for the IOL but also helps determine the IOL options available for each patient.  Read more... Based upon the results of the various measurements and testing, recommendations are made to each patient following discussion with our Optometrist, Cataract consultants and your Surgeon. In the past a Standard Monofocal IOL was implanted in all patients, and provided good distance vision, which was usually improved with glasses for driving and bifocals or readers were always needed. These Standard IOLs did not correct for astigmatism and a prescription for astigmatism was added to the distance glasses and readers. Over the past several years there have been remarkable advances in IOL technology, providing patients with options for improved visual quality, astigmatism correction and even reading correction. While there is an added cost to these IOLs, the benefits to vision improvement are significant and long-lasting.

There are basically three types of lens implants to be considered in your surgical planning:

  1. Standard
  2. Premium
  3. Presbyopic

Standard lenses are generally offered at the hospital and will correct your distance vision only. While these Monofocal lenses will work adequately for most people, they don’t correct for astigmatism, your reading vision or have the ability to optimize your vision in low light conditions.


The Cataract Procedure

Like the advances made with Intraocular Lens Implants, cataract surgery has advanced considerably. The entire procedure is usually performed under local anesthetic or even topical eye drops, on an outpatient basis. Although patients are in the clinic for a couple of hours, the procedure requires less than fifteen minutes in general. Read more... In the early days of cataract surgery more than two decades ago, a large incision was made to remove the cataract which required hospital stays and a long visual recovery. Today, very small incisions are made into the eye to remove the cataract, using phacoemulsification or ‘phaco’ for short, the cataract is broken up into very small pieces using high frequency ultrasound and aspirated out of the eye. The IOL is then inserted into the eye behind the pupil, through the small incision.

For years ‘phaco’ was often referred to as ‘laser’ by patients, but today lasers are being advanced for cataract surgery. Dr. Tayfour has traveled to Europe to determine the best and most advanced technology and we are pleased to be able to offer our patients the Victus femtosecond laser from Bausch & Lomb, a trusted leader in ophthalmic technology at Crystal Clear Vision. Femtosecond laser technology was introduced to LASIK surgery more than a decade ago, and has improved the safety and precision of LASIK surgery, reducing and in many cases, eliminating many of the most serious intra-operative and post-operative problems. Just as femtosecond laser technology has revolutionized LASIK, we are now seeing it revolutionize cataract surgery.

The Victus femtosecond laser is used to create the critical first opening into the capsule which surrounds the cataract. The laser opening replaces the surgeon created opening, which is done by hand. The Victus capsulotomy or opening is incredibly precise and consistent, creating a perfectly sized, perfectly round, and perfectly centered opening in 6 seconds. The Victus laser then performs lens fragmentation, breaking the cataract into smaller segments to make removal easier. The amount of phacoemulsification energy is reduced substantially, making the procedure less traumatic for the eye. This second step takes seconds as well. Patients do not feel anything during these steps. There is no discomfort, no bright lights. The Victus laser is also capable of making the entrance wound and can treat corneal astigmatism. Since introduced in 2013, each and every cataract or lens surgery patient at Crystal Clear Vision has benefitted from the use of the Victus laser technology.

Both Cataract surgery and Refractive Lens Exchange(RLE) can be performed with the Victus laser. RLE is a procedure where the natural crystalline lens is removed prior to cataract formation, in patients unable to have LASIK. RLE is performed in patients over 40, who are presbyopic in order to correct more complicated prescriptions or to provide both distance and reading vision improvement in patients.

At Crystal Clear Vision we also offer Implantable Contact Lens(ICL) surgery. As the name implies, it is a procedure which inserts an implant intraocularly in front of the natural crystalline lens, much in the same manner that a contact lens sits on the cornea. The ICL surgery, is another option for patients with very high prescriptions that are unable to have LASIK but still young enough to have good accommodation and reading vision.

Our goal at Crystal Clear Vision is to provide patients with the most advanced and safest technology available to improve their vision. Equally important is that we strive to create a warm, professional and caring atmosphere. Having any type of eye surgery, whether you are considering LASIK at 25, KAMRA at 45 or cataract surgery at 75, can be very emotional and even frightening. We want you to feel secure at every step of the process that you are in good hands, experienced hands, compassionate hands. Our cataract patients, like the fact that we can schedule them usually within 1-2 months, and that most patients have their second eye treated the very next day, allowing them to return to their normal daily activities. Hundreds of eye care professionals have referred their friends and family members to Dr. Machat and Dr. Tayfour, and hundreds more have come themselves to have surgery with them. There are many amazing private eye clinics in Toronto, but time and time again, patients share with us, that after visiting several clinics, they felt most comfortable at Crystal Clear Vision. Each and every member of our staff is very proud of the care we provide to each and every patient that walks through our doors. Our entire staff shares a deep commitment to patient care, and your safety. Hide...