Custom Cataract Surgery
Laser Cataract Surgery - Lens Implants (IOL)
Drs. Rolando and Melissa Toyos have combined over 40 years of Cataract Surgery experience. Both doctors were named Innovators in Refractive Cataract Surgery by Ocular Surgery News 2016.
Custom Cataract Surgery
Toyos Clinic has been in the forefront of new technology in cataract surgery. Ocular Surgery News, OSN, named Drs. Rolando and Melissa Toyos - Innovators in Refractive Cataract Surgery -, a list of premium refractive cataract surgeons the editors and publishers have identified as leading innovators in the field of refractive cataract surgery. OSN - "These surgeons work to educate their colleagues, innovate by developing novel technologies and techniques to advance the premium practice or perform a high volume of premium refractive cataract surgery". One new innovation in cataract surgery is the use of lasers. Dr. Rolando Toyos has performed several laser cataract procedures utlizing several different laser technologies. He was voted Top Doc for Refractive Surgery by Castle Connolly. Before joining Toyos Clinic Dr. Melissa Toyos was the President of the Missouri Society of Eye Physicians and Surgeons and was a partner in one the largest practices in the state. Toyos Clinic has been involved in several cataract research studies over the years and lectures around the world on cataract surgery technology and techniques. In cataract surgery a patient's natural dysfunctional lens is replaced with a new artificial lens. We have many choices of FDA approved implantable lenses that can achieve the desired goal of the patient. We help you decide what type of cataract surgery and lens is best for your specific needs. This type of individualized care is called Custom Cataract Surgery (CCS). CCS requires special pre testing technology, statistical analysis, and access to the latest technology for surgery. The final ingredient for CCS is a thorough discussion with the patient about their vision needs. Then taking the scientific knowledge and patient goals we can schedule a surgery that can meet the patient's expectations.
Vision Simulation of Before and After Cataract Surgery
What is a Dysfunctional Lens?
After the age of 40 many patients begin to experience decrease vision at near and sometimes at distance. As we age our natural lens lacks the flexibility to focus correctly. The condition worsens each year. We have used our knowledge in Custom Cataract Surgery to perform Refractive Lens Exchange (RLE) where a dysfunctional lens is replaced by a FDA approved advanced lens to attain spectacle freedom. Patients that have RLE surgery will not need cataract surgery later in life because they have essentially have already had their natural lens replaced.
What is a Cataract ?
Your eye has a clear lens through which light passes, allowing you to see. When the lens loses its transparency, the cloudy tissue that develops is known as a cataract. Cataracts cause progressive, painless loss of vision. The lens clouds naturally as we age - people over the age of 65 usually see a gradual reduction of vision. No one is exactly sure what causes cataracts. Although cataracts usually develop without apparent pain, some indications that a cataract may be forming are as follows:
Blurred or Hazy Vision
Double Vision
Poor Vision in Bright Light
Seeing Halos Around Lights
Yellowish Tinged Vision
Night Vision Difficulty
If visual impairment interferes with your ability to read, work, or do the things you enjoy, then you should consider cataract surgery. Surgery is the only proven means of effectively treating cataracts. Most of our patients find that cataract surgery is not an uncomfortable procedure, they are often amazed of how quick and easy the process can be.
Cataract surgery has become one of the surgical procedures more oftenly performed across the country, with our no stitch - no shot procedure patients return to their normal lives as soon as the day after surgery. The procedure consists of removing the cataract and replacing it with an artificial intra ocular lens or IOL. Toyos Clinic utilizes all the available lenses. We offer all of the FDA approved IOLs. We are also involved in FDA studies for new lenses. We will inform you beforehand if you are a candidate for one of these studies and ask for consent if you are interested. For the latest news on cataract surgery you can go to our blog and type in cataract surgery in the search engine.
Secondary Cataract - Posterior Capsule Opacification
Your vision could become cloudy or blurry weeks, months or years after cataract surgery. This is not unusual. Your doctor might call this a “posterior capsular opacification (or PCO).” It's also called "secondary cataract" or "scar tissue." It's not like a scar you get on your skin. But because it happens after the eye has healed from cataract surgery, some people think of it as a scar. It happens when a membrane called the posterior capsule becomes cloudy. It might help to think of the posterior capsule as a transparent pocket. It holds your IOL in place. It also once held your eye’s natural lens (what became the cataract) in place. If you notice cloudy vision again, you might need to have a laser procedure. The laser creates an opening in the cloudy capsule and is called a posterior capsulotomy (or a YAG laser capsulotomy). This procedure helps restore clear vision.
Explanation of Cataract and Surgery
from the American Academy of Ophthalmology Website
Cataract surgery is an operation to remove your eye’s lens when it is cloudy.
The purpose of your lens is to bend (refract) light rays that come into the eye to help you see. Your own lens should be clear, but with a cataract it is cloudy. Having a cataract can be like looking through a foggy or dusty car windshield. Things may look blurry, hazy or less colorful.
The only way to remove a cataract is with surgery. Your ophthalmologist will recommend removing a cataract when it keeps you from doing things you want or need to do. During cataract surgery, your cloudy natural lens is removed and replaced with a clear artificial lens. That lens is called an intraocular lens (IOL). Your ophthalmologist will talk with you about IOLs and how they work.
What to Expect with Cataract Surgery
Before surgery
Your surgeon will measure your eye to determine the proper focusing power for your IOL. Also, you will be asked about any medicines you take. You might be asked not to take some of these medicines before surgery. You may be prescribed eyedrop medicines to start before surgery. These medicines help prevent infection and reduce swelling during and after surgery.
The day of surgery
Your ophthalmologist may ask you not to eat any solid food at least 6 hours before your surgery. Cataract removal surgery may be done in an outpatient surgery center or in a hospital. Here is what will happen:
Phacoemulsification
With phacoemulsification cataract surgery, an ultrasound instrument breaks up the center of the cloudy lens and suctions it out.
Your eye will be numbed with eye drops or with an injection around the eye. You may also be given a medicine to help you relax. You will be awake during surgery. You may see light and movement during the procedure, but you will not see what the doctor is doing to your eye. Your surgeon looks through a special microscope. She creates tiny incisions (cuts, created by laser or a blade) near the edge of your cornea. The surgeon uses these incisions to reach the lens in your eye. Using very small instruments, he or she will break up the lens with the cataract and remove it. Then she puts your new lens into place. Usually your surgeon will not need to stitch the incisions closed. These “self sealing” incisions eventually will close by themselves over time. A shield will be placed over your eye to protect it while you heal from surgery. You will rest in a recovery area for about 15–30 minutes. Then you will be ready to go home.
Cataract Surgery Recovery
Days or weeks after surgery: You will have to use eye drops after surgery. Be sure to follow your doctor’s directions for using these drops. Avoid getting soap or water directly in the eye.
Do not rub or press on your eye. Your ophthalmologist may ask you to wear eyeglasses or a shield to protect your eye. You will need to wear a protective eye shield when you sleep.
Your ophthalmologist will talk with you about how active you can be soon after surgery. He or she will tell you when you can safely exercise, drive or do other activities again.
What Are the Risks of Cataract Surgery?
Like any surgery, cataract surgery carries risks of problems or complications. Here are some of those risks:
Eye infection.
Bleeding in the eye.
Ongoing swelling of the front of the eye or inside of the eye.
Swelling of the retina (the nerve layer at the back of your eye).
Detached retina (when the retina lifts up from the back of the eye).
Damage to other parts of your eye.
Pain that does not get better with over-the-counter medicine.
Vision loss.
The IOL implant may become dislocated, moving out of position.
Cataract surgery will not restore vision lost from other eye conditions such as macular degeneration, glaucoma, or diabetic retinopathy. Your ophthalmologist will talk with you about the risks and benefits of cataract surgery.
Posterior Capsular Opacification
Your vision could become cloudy or blurry weeks, months or years after cataract surgery. This is not unusual. Your doctor might call this a “posterior capsular opacification (or PCO).” It's also called "secondary cataract" or "scar tissue." It's not like a scar you get on your skin. But because it happens after the eye has healed from cataract surgery, some people think of it as a scar. It happens when a membrane called the posterior capsule becomes cloudy. It might help to think of the posterior capsule as a transparent pocket. It holds your IOL in place. It also once held your eye’s natural lens (what became the cataract) in place. If you notice cloudy vision again, you might need to have a laser procedure. The laser creates an opening in the cloudy capsule and is called a posterior capsulotomy (or a YAG laser capsulotomy). This procedure helps restore clear vision.
Cataract Surgery Costs
Cataract surgery costs are generally covered by Medicare if you are Medicare eligible. Private insurance usually covers cataract surgery as well. Medicare will cover your costs if your vision tests at a certain level of acuity or clarity. Private insurance plans may have similar vision requirements. If your surgery is covered you may still have some costs. Special types of IOLs will cost more. Choosing to have cataract surgery before your vision has deteriorated enough will cost more.
In certain cases, it might be possible to get coverage before you meet the age or vision requirements. Talk with your ophthalmologist if you are considering having early cataract surgery.
What do you do if you don't have Medicare or private insurance coverage? You may still be able to reduce and manage the cost of cataract surgery. Ask about payment plans through your doctor's office. See if your employer offers flexible spending accounts that can help. Your ophthalmologist can help you learn more about costs of cataract surgery. Discuss your options for affording the procedure.