Dr. Paul Krawitz has performed thousands of No Stitch-No Shot-No Patch Cataract Surgery. He will personally take the time to thoroughly evaluate your unique situation and to speak to you about all of your options. As of April 14, 2006, Dr. Krawitz is the only ophthalmic surgeon in Suffolk County, Long Island to be certified in monofocal lens implants, multi-focal lens implants such as ReZoom, and accommodative lens implants such as Crystalens. To make an appointment for a consultation and see the difference that personal attention and an experienced surgeon makes, call us at (631) 223-0400.
The following article was written by Dr. Krawitz and reprinted by numerous publications for its clarity and completeness.
Forget what you've heard on those radio advertisements. Laser cataract surgery still requires a surgical incision and is not done in the doctor's office. What they are saying on those commercials is, "laser and cataract surgery," not "laser cataract" surgery. That being said, laser cataract surgery was recently approved by the FDA. Will it be better or easier than the modern current methods? Not necessarily.
Cataract surgery is the most frequent surgery performed annually in the United States. Why then, with the preponderance of lasers in modern medicine, can't it be done without the need for surgery? To understand the answer to this question, you must first understand what a cataract is. First, let's dispel a couple of common myths. A cataract is not a veil that grows over the eye. Nor is it a new growth inside the eye.
Every eye has a lens in its center that helps to focus light and images on the retina, the inner lining of the eye. When we are born, that lens is perfectly clear and soft like gelatin. As we age, the lens becomes harder and less clear. Exposure to ultraviolet light and diseases such as diabetes may hasten that process.
When the lens is sufficiently opaque to obstruct vision, the lens is then said to be cataractous, or more simply, a cataract. The trick to cataract surgery, then, is how to get a lens that is slightly less than one-half inch wide out of the eye and still allow the patient to see well.
When cataract surgery was first being developed, a large surgical opening was made, the cataract was taken out in one piece, and the wound was sewn shut. The problem with these early surgeries was that when the cataract lens was removed, nothing was put back into the eye to take its place. And without a lens inside the eye, even a cataractous lens, the vision was blurred. In order to make the vision clear, patients required thick eyeglasses or contact lenses after the surgery, to replace the function of their previous lens.
Eye surgery made a great advance when, after removing the cataract lens, a replacement lens was put back into the eye where the cataract previously resided. This is called a lens implant, and early intraocular lenses were made from hard acrylics.
The most recent advance in cataract surgery is "no-stitch" or small incision cataract surgery. In this procedure, a small probe is placed inside the eye through a wound that is only one-eighth of an inch in diameter. Using high-energy sound waves, called ultrasound, the lens is dissolved into many small pieces which are then vacuumed up using the same probe. Because the lens is being dissolved, or emulsified, this procedure is known as phacoemulsification. The lens implants that are then put in are foldable, enabling them to fit through the one-eighth inch wound, but then unfolding inside the eye to their full half-inch size.
Laser cataract surgery, as it is being experimentally tested, uses laser light rather than ultrasound to dissolve the cataract. But it still requires a surgical opening in the eye, just like phacoemulsification surgery. The magic to modern cataract surgery is that it allows removal of a half-inch lens through a one-eighth inch opening.
But no surgery currently exists, or is anticipated, that can remove this lens without a surgical opening.
Phacoemulsification surgery of cataracts through a small incision offers patients many benefits. Because the wound is exceedingly small, often there are no stitches that can cause irritation. The small wound is strong and water-tight, allowing for participation in full activities immediately after the surgery. And lastly, because the small wound doesn't drastically alter the shape of the eye, the vision often is perfectly clear much sooner than surgeries with large surgical wounds.
The next great technological advance in the treatment of cataracts is yet to come. Perhaps smaller instruments will allow for smaller wounds. Maybe a new medication will prevent the natural tendency of the lens to opacify. But one thing is certain: modern cataract surgery has already evolved into a state-of -the-art procedure that improves the quality of life for patients worldwide.
