Laser Cataract Removal

Various lens options available for patients who have undergone LASIK™ surgery.

A retired special education teacher, Barbara Hubbard left behind the cold, harsh winters in Illinois and migrated south to spend her golden years basking in the warm Florida sunshine.Barbara Hubbard underwent cataract surgery with the femtosecond laser at the hands of Nathan Emery, MD, at Pasadena Eye Center in Pinellas County.

During her years in the classroom, Barbara recalls needing to wear reading glasses while doing tasks such as grading papers or working on her computer. She also wore contact lenses with monovision, meaning one eye is corrected for distance and the other for reading.

But, when Barbara grew tired of misplacing pair after pair of her readers and felt inconvenienced at the idea of putting in her contact lenses, she decided a permanent solution was needed.

“I was always losing my reading glasses or forgetting where I put them,” Barbara shares. “Then, I developed dry eye syndrome, and that made me dread putting in the contacts because my eyes would itch all the time. I just wanted a long-term solution.”

First steps

After hearing and reading about it, Barbara decided to undergo LASIK [laser-assisted in situ keratomileusis] surgery to correct her vision.

“I was thrilled with the results,” Barbara recalls. “I didn’t need glasses or contacts for many, many years. Then, as I aged, I found my eyesight was blurry again.”

“I had some difficulty driving at night with halos and that kind of thing,” Barbara recalls. “My day vision was a little blurry as well.”

Most recently, Barbara sought the expertise of Nathan R. Emery, MD, a board-certified ophthalmologist at Pasadena Eye Center.

During an annual eye examination, it was determined that “Barbara’s eyes were developing cataracts, which all of us develop at some point,” Dr. Emery explains.

When cataracts develop, people describe a variety of symptoms, including a loss in the vibrancy of colors or the need for frequent changes in eyeglass prescriptions. It also becomes increasingly difficult to read, especially in low-light situations.

After reviewing her history, Dr. Emery suggested cataract surgery with monovision lens correction, as Barbara was already used to that following her LASIK surgery years earlier.

Dr. Emery wants readers to understand that LASIK surgery does not prevent the formation of cataracts.

“Cataracts are something all of us develop as we age, and the only way to ultimately eliminate them is through surgery,” he explains.

Femtosecond laser technology

Pasadena Eye Center is thrilled to be able to offer patients like Barbara femtosecond laser technology.

Dr. Emery used the femtosecond (bladeless) laser to remove her cataracts, while at the same time correcting Barbara’s astigmatism. Astigmatism is a result of an irregular corneal shape that distorts vision at all distances.

The femtosecond laser surgery is the most technologically advanced procedure for the removal of cataracts in patients who also have astigmatism. The laser provides unmatched accuracy, as each procedure is customized to the specific patient’s eye.

“With the femtosecond laser-
assisted tool, the laser makes the incisions, both on the surface of the eye and inside the eye, and it is a consistently precise incision,” Dr. Emery explains. “We commonly refer to the incision which treats astigmatism as an LRI, which stands for limbal relaxing incision.”

The laser divides the cataract into segments that are then removed. The surgery can be performed with greater efficiency and accuracy using the femtosecond laser.

Lens options

It is routine for patients to have intraocular lens (IOL) implants after cataract removal. Based on the health of the eye and factors determined in the pre-surgical exam, Dr. Emery then decides which lens to use and discusses these options with each patient. Many factors are taken into consideration when choosing the proper lens, including the needs of the individual and their long-term goals.

Monofocal lens: These lenses are the most commonly implanted lenses today. They have equal power in all regions of the lens and can provide high-quality vision, usually with only a light pair of spectacles. Monofocal lenses are in sharpest focus at only one distance. They do not correct pre-existing astigmatism. People with significant astigmatism require corrective lenses to have the sharpest vision at all distances. Patients who have monofocal intraocular lenses implanted usually require reading glasses.

Multifocal lens: Multifocal intraocular lenses are one of the latest advancements in lens technology. These lenses have a variety of regions with different powers that allow some individuals to see at distance, intermediate and near ranges. While promising, multifocal lenses are not for everyone. They can cause more glare than monofocal or toric lenses. Multifocal lenses cannot correct astigmatism, and some patients still require glasses or contact lenses to achieve the clearest vision.Barbara Hubbard underwent cataract surgery with the femtosecond laser at the hands of Nathan Emery, MD, at Pasadena Eye Center in Pinellas County.

Toric lens: Toric lenses have more power in one specific region in the lens to correct astigmatism, as well as distance vision. Due to the difference in lens power in different areas, the correction of astigmatism with a toric lens requires that the lens be positioned in a very specific configuration. While toric lenses can improve distance vision and astigmatism, the patient still will require corrective lenses for all near tasks, such as reading or writing.

Optimal health

Dr. Emery stresses the importance of annual eye exams.

“Various diseases can develop that, in their initial phase, can cause damage that the person is unaware of until it is too late to reverse the damage caused, like glaucoma or macular degeneration,” he explains. “We call those the ‘silent thieves of sight.’ Those are great examples of reasons to have an annual eye exam to make sure those types of diseases are not developing.”

In fact, Barbara says it was during an annual exam that she found out about her cataracts.

“Annual exams really are important,” she adds. “I had no idea I had cataracts until I saw Dr. Emery.”

Barbara is happy that she decided to have the cataracts removed early on, rather than waiting until they got worse.

“I heard a lot of stories about how bad your eyesight can get with cataracts, so I didn’t want to wait. I’m glad I chose to do it now. My eyesight is wonderful again. Crystal clear.”

Barbara says she is thrilled with the care she receives at Pasadena Eye Center.

“Dr. Emery and the entire staff are knowledgeable and patient and treat you like family,” Barbara raves. “I have recommended them to many people I know, and I will continue to do so. They are fabulous!”

FHCN article by Judy Wade. Photos by Jordan Pysz.
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