What is a Cataract?

A cataract is a clouding of an eye’s natural crystalline lens. As a cataract becomes ripened it yellows in color making it hard to see through and dulls colors. Night driving can become difficult and dangerous. Many people describe the cataract sensation as looking through wax paper. Cataracts are an almost inevitable feature of aging. Although they generally do not affect vision until after age 60, they can occur earlier.

Cataract Surgery

The only medical treatment available for cataracts is the surgical removal of the clouded lens. Cataracts are removed on an outpatient basis, and there is generally no discomfort and a speedy recovery of vision. Cataract surgery has existed in this world for over a century, but it is the recent innovations in technology that have transformed this into a very safe and effective surgery. As a patient, it’s great to know that the success rate for cataract surgery is high when you are about to undergo this type of surgery. Cataract surgery is actually the most reimbursed medical surgery by Medicare today! Advanced artificial intraocular lenses inserted during phacoemulsification have allowed cataract patients to recover more youthful eyesight. Instead of dealing with glasses after surgery some patients may have the choice to upgrade to a new premium type of lens that will enable vision at multiple distances.

Procedures today are performed using phacoemulsification through a small self sealing incision so sutures are not needed. The eye is completely numbed using eye drops, eliminating the need for a painful needle injection. To compensate for the removal of the lens of the eye, an intra-ocular lens (IOL) is implanted into the eye. The new technology multifocal and accommodating intraocular lenses restore clear distance and near vision, reducing or eliminating the need for glasses after cataract surgery. New technology toric IOLs correct astigmatism giving clearer vision.

With no-stitch surgery, many patients can see clearly soon after the surgery. With eye drop anesthesia, the eye is not patched and it is possible to resume most daily activities within a day or two.

In addition to the new lens implants available, less invasive surgery techniques have come to fruition to enable much faster healing. Despite the effectiveness of the cataract surgery the preparation process may take weeks and various decisions will need to be made.

NOTE: Charles Kelman, MD had created the modern style of cataract surgery we use today known as phacoemulsification in 1967.

Cataract Surgery Choices

Once you have decided to have cataract surgery you will have a number of important decisions to make. The first item on the agenda is to select a skilled cataract surgeon. If you are seeking a cataract surgeon in Hawaii, our eye doctors at would be more than happy to be your cataract surgeons of choice. We have the most up to date and modern surgery techniques available to our patients and skilled cataract surgeons to help ensure a safe procedure. Once you have selected a cataract surgeon it is time to understand what lens implant option will be the best. It’s important to discuss your options with a qualified ophthalmologist. Your options will include monofocal lenses, multifocal IOL’s or accommodating lens implants.

The Cataract Surgery Process

After the proper anesthesia and numbing of the eye your cataract surgeon will create a small incision in your eye about 3mm wide. Modern day cataract surgery is also called micro-surgery because the incision sizes have become so small. Once the incision is made the cataract surgeon will insert a probe to break up the cloudy cataract and then remove the material. A suction tube will remove all of the loose debris and the capsular bag is prepared for the artificial IOL implant. The foldable IOL is then inserted through a tube and then unfolds once in place. Intraocular lenses will have haptics and “lens arms” to hold it in place. With the cataract removed and the IOL in place, light can once again travel unimpeded to the back of the eye and focus on the retina where the image is interpreted and transmitted to the brain. The end result is clear youthful vision.

Determining Your Cataract Lens Implant

An important part of your pre-operative process will involve choosing a lens implant. Implants are divided into 2 main categories:

How do Monofocal and Multifocal Lenses Work?

Monofocal lens implants work when light enters the actual lens and it is bent to a specific focal point. As the power of the monofocal lens becomes stronger, its ability to bend light more sharply is increased. Because the lens is monofocal, the light can only be bent to one focus point at a time. The light from these lenses is bent to focus specifically on the retina of the eye. New lens implants are now available that can correct vision at near, intermediate and far distances. These types of lenses are commonly called “lifestyle lens implants” or premium lens implants and fall into the categories listed below. Multifocal, toric, and accommodating lens implants are all considered premium lens implants

How do Premium Lens Implants Work?

As we perform daily activities such as reading, watching television or working at the computer, our eyes are constantly focusing on objects at varying distances – up close, far away and everything in-between. The ability to quickly change focus throughout this range of vision is called accommodation. Unfortunately, this ability diminishes, as we grow older, causing us to become dependent on bifocals or reading glasses. However, premium lenses are designed to provide quality vision for near, intermediate and far distances by combining the strengths of apodized diffractive and refractive technologies. Similar technology has been used for years in microscopes and telescopes to improve image quality. Read more about our Premium Lens Implant Options.

After Cataract Surgery

Most patients are concerned about the cataract surgery recovery process. Our doctors provide the best quality care and thoroughly explain what you can expect after cataract surgery. Recovery from cataract surgery is generally very quick. Most patients obtain better vision within the first 24 hours of the procedure. Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, any moderate discomfort should disappear. Complete visual recovery varies from patient to patient but most patients return to their every day activities within a day or two. If you have cataracts in both eyes, the second procedure will most likely be scheduled within a week or two. Your doctor will schedule exams to check on your progress. Each person heals differently so it is important to discuss the cataract surgery recovery with your eye doctor.

For a few days after surgery, your doctor may ask you to use eye drops to help healing and decrease the risk of infection. Ask your cataract eye doctor about how to use your eye drops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.

Serious complications are extremely rare but because it is a form of surgery, there are some potential risks involved. Our staff and cataract surgeons will provide you with additional information about the risks associated with cataract surgery and answer any of the questions you may have.

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Queen's Physicians' Office Building
1380 Lusitana Street, Suite 714
Honolulu, HI 96813