WHAT IS A CATARACT?

A cataract is the clouding of the natural lens inside the eye. While cataracts can develop at any age, for most of us cataracts are a normal part of growing older. In addition to age, smoking, diabetes, past eye infections, injuries or surgery, some medications (such as steroids) and exposure to the sun’s ultraviolet light have been shown to increase the risk of developing cataracts. Symptoms are usually subtle at first, but as a cataract develops (the lens becomes cloudier) you may experience blurred vision, difficulty reading, glare, halos around lights (especially at night), decreased ability to appreciate vivid colors, and frequent changes in your eye glass prescription. Many people notice a diminution of vision and just think their glasses need changing.

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HOW IS IT TREATED?

Surgery is the only way to remove a cataract and restore clear vision by replacing your cloudy natural lens with a clear, permanent implant called an intraocular lens (IOL). Diet cannot be used as a treatment nor are there any drops or other medications that treat cataracts.

There are two IOL replacement options. One is the standard IOL which allows you to see at a distance. However, for most intermediate and/or up-close tasks, glasses may be necessary.

The other IOL option is a multifocal lens, or accommodating implant, sometimes called presbyopic correcting lenses. With these lenses, like the standard lens, they provide very good distance vision but also focus for intermediate and near vision. Our refractive cataract specialists will be glad to review all your options during your exam.

WHAT TO EXPECT

At The Eye Institute, our patients are fortunate to have available to them the premier outpatient surgery center in this region. The Largo Ambulatory Surgery Center is designed specifically for eye surgery. Our team of staff members is hand picked and specially trained to provide the very best care. Because all these elements come together with our doctor’s extraordinary surgical skills, you can expect a comfortable procedure followed by quick dramatic improvement in your vision for a speedy return to all your favorite activities.

THE SURGERY

Cataract	Remove Cataract	Intraocular Lens Placement	Restored Vision

“I wanted to express my thanks to each and everyone who showed such care and concern before, during and after my cataract surgery. I am extremely satisfied with the results and impressed with the wonderful way you treat all your patients! As far as I am concerned, you are a top notch team of professional individuals!” - K. R.

MODERN DAY CATARACT SURGERY

After your personal cataract consultation and before your surgery, you will have several tests designed to allow your doctor to match the new lens implant to your needs.

When you arrive at the ambulatory surgery center, your eye will be numbed with anesthetic eye drops. In the sterile operating room an incision of less than 2mm is made in the clear cornea of the eye.

The cataract is broken into microscopic particles using ultrasonic waves and then gently removed from the eye. The lens selected especially for you is then implanted to replace the natural lens. If you have any astigmatism (irregularity in the shape of the eye) it too can be treated at the time of surgery to insure better vision without glasses.

The incision is usually self-sealing so that no stitches are needed. There is generally no pain and no patch and you can return home immediately. Your surgeon will check your operative eye the day after surgery. Then it’s back to living life and doing all the things you enjoy – from playing golf, swimming or driving – without restriction and with reduced dependence on glasses.

ASTIGMATISM CORRECTION

What is Astigmatism

Astigmatism is a condition where the cornea is not perfectly round but is oval shaped, causing blurred vision.

Rather than having a symmetrical, circular cornea shaped like a basketball, patients with astigmatism have a slightly oblong cornea shaped more like a football. It is curved differently from one side to the other. Because this bends light rays entering the eye unequally, there is a distortion of the image on the retina, resulting in blurred vision. Uncorrected astigmatism causes ghosting or shadowed images.

Astigmatism Correction Procedures

Fortunately, today we can correct the astigmatism during cataract surgery or the clear lens extraction (CLE) procedure. Using precisely measured incisions, we equalize the curves on the cornea, which reduces or eliminates the astigmatism. The surgery, known as a limbal relaxing incision (LRI) or astigmatic keratotomy (AK), creates a more spherical cornea.

The limbal relaxing incision (LRI) procedure using the new ORange® Intraoperative Wavefront Aberrometer by Wavetec Vision Systems pioneered by Dr. Robert Weinstock and Dr. Neel Desai, or the Toric Lens Implant, offer patients with as much as 4 to 5 diopters of astigmatism a choice of vision correction procedures.

When a patient has astigmatism, as well as a cataract, the astigmatism must be corrected in order to see clearly with either a standard lens implant or a lifestyle intraocular lens (IOL). If left uncorrected, glasses will be required to see clearly.

Correcting Astigmatism using New Technology

Correcting astigmatism can be a challenge. Achieving the best results is mostly determined by the accuracy and precision of the surgeon. As refractive specialists, and the only facility in Florida to provide such technology, we helped develop the new ORange™ Intraoperative Wavefront Aberrometer by WaveTec Vision Systems for more predictable results. This system uses real-time analysis to determine if your astigmatism has been eliminated while we are performing your surgery.

As new cataract surgery techniques shorten the recovery time and improve results, we are entering into an era of unprecedented growth in the development of innovative technologies in the field of ophthalmology. Our surgeons are pioneers of this technology and are currently training other surgeons to in their use around the world. The Eye Institute of West Florida, in 2009, was one of only five surgery centers worldwide to use the wavefront-guided cataract surgery procedure. We are committed to exploring the forefront of innovation and providing proven technologies to the people of Tampa Bay and Florida.

Toric Lens

Another option for patients who have a large amount of astigmatism is a lens replacement implant known as a toric IOL, which corrects astigmatism without having to make extra incisions on the eye. The goal of the toric lens is to improve the range of vision for patients considering cataract surgery or the clear lens exchange procedure. It corrects patient’s astigmatism just as glasses do.

Stephen M Weinstock, M.D., F.A.C.S., is a cataract and LASIK specialist. He founded The Eye Institute of West Florida in 1974, pioneering sub-specialty eye care in Pinellas County. Today, as President and Medical Director, Dr. Weinstock is recognized as a world renowned cataract and LASIK surgeon. He teaches the latest techniques such as “no-stitch, no-patch” cataract extraction and implantation of premium intraocular lenses (IOLs), here and abroad. Dr. Weinstock is also very proud of being the first ophthalmologist to introduce the excimer and YAG lasers to Pinellas County. In 1999 for his outstanding performance as a refractive surgeon, Dr. Weinstock was honored with the “VISX Star Surgeon” award and placed in the top 5% of refractive surgeons nationwide. He is one of the only surgeons in the country who has been certified by the American Board of Eye Surgery in both Cataract and LASIK surgery. Dr. Weinstock is also an associate clinical professor of ophthalmology at the University of South Florida.

Robert J. Weinstock, M.D. is a board-certified ophthalmologist and is fellowship-trained in cataract and refractive surgery. He became interested in ophthalmology at an early age - as he watched and assisted his father. Dr. Weinstock has joined the practice in 2001 after completing his residency at the St. Louis University School of Medicine. He is the Director of Cataract and Refractive Services at the Eye Institute of West Florida and The Weinstock Laser Eye Center. He also is an associate clinical professor of ophthalmology at the University of South Florida, and serves as the Surgical Director of the Largo Ambulatory Surgery Center. He was named one of 250 in Permier Surgeon's List of Leading Innovators of 2010 for his contributions to cataract surgery and premium IOLs. In addition to performing thousands of vision correcting cataract and LASIK procedures each year, Dr. Weinstock speaks and teaches nationally and internationally on customized cataract surgery and surgical innovations. He is continuously engaged in clinical research and studies to evaluate new technology, many of which are sanctioned by the FDA. He is recognized internationally as an expert on new implant technology and microincisional surgical techniques. He has authored many book chapters on cataract surgery and continues to write journal articles on cataract and refractive surgery

Neel R. Desai, M.D. is a fellowship-trained ophthalmologist strictly specializing in LASIK, cataract and corneal diseases of the eye. Dr. Desai is a top graduate of the Pennsylvania State University College of Medicine and completed his fellowship in cornea, cataract and refractive surgery at the Wilmer Eye Institute at Johns Hopkins University. He is recognized throughout the country and internationally as one of only 100 surgeons able to perform advanced corneal transplants and other complex cataract, corneal and refractive procedures. He holds pending patents to new surgical products and advanced cornea surgical procedures of his own design. Additionally, Dr. Desai has authored many book chapters in his field of study and continues to write articles in peer review journals.