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High-Tech Procedures Make Cataract Surgery a Breeze

2/3/2021

When your focus and eyesight deteriorate suddenly, it may be because you've developed cataracts. That means you need to have the lenses inside your eye replaced. But not to worry. With laser surgery and other technologies, replacement is a breeze, and your sight will improve immediately.

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"Healthy Living in the Four Corners"

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is brought to you by

Southwest Eye Consultants.

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Are you experiencing blurry vision

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or seem to be seeing double?

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Do you have trouble seeing well at night?

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You may be experiencing the

development of cataracts,

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a condition that affects

one out of every two people

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after the age of 60.

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We asked Dr. Moss Fenberg

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with Southwest Retina

Consultants of Durango

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about cataracts and

the latest technologies

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that are available to replace

them and improve your vision.

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So as we age, there is a

natural clouding that happens

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in your lens inside your eye.

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Your lens is a clear crystalline

protein that helps to,

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of course, focus light inside your eye.

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As the birthday candles come,

we tend to have less ability

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for that crystalline

lens to focus or move,

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which changes our focal point,

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meaning our arms are

not long enough anymore.

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We can't quite bring

images as close as we want,

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and also there's a general

clouding that occurs.

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So that light is no longer distributed

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through the lens equally,

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and we start to develop

opacities there in the lens

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and we go see our optometry

colleagues who make our glasses

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and do our comprehensive evaluations,

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and they say at some

point, "Well, I'm sorry.

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I can't get you back to 20-20 any longer.

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You need to go see an ophthalmologist

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and consider cataract surgery."

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Cataract surgery is the removal of that

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hard, cloudy crystalline lens in your eye

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and the replacement of it with

an acrylic or plastic implant

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that is designed to focus

light where it should,

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and so although that may

seem strange to think about,

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an implant inside your eye,

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it's a lot like an implant to replace

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a different part of your

body that isn't working well.

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Your eye is essentially measured

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like a fitting for a shoe,

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and all of the angles and curves

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and length of the eye are

brought into consideration,

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and then a lens is chosen

that is right for you,

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and that new lens

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then focuses light

properly in the eye again.

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Cataract surgery traditionally

has been performed

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by hand with surgeons magnifying

the eye with a microscope.

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Dr. Fenberg also employs laser technology

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to ensure the finest precision possible.

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With laser assisted cataract surgery,

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before the physician does anything,

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the laser makes that incision

with a laser, essentially.

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The laser then opens

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with a perfectly round capsulotomy

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here on the center of

the lens in the capsule,

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and then the laser sculpts

this lens into multiple pieces.

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You imagine cutting a

pie into multiple wedges.

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It's all broken into those

pieces, but not removed.

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So then the patient is moved

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under the microscope with the physician.

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These incisions that have been

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perfectly made with the laser are opened.

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The capsulotomy is essentially removed,

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because it's already been

placed perfectly in the eye,

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and then with much less power

and much less manipulation,

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each of these little quadrants is removed

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from the eye of the lens,

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and then you began the process of,

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on the table, measuring

the patient one more time

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to ensure that the lens you've

chosen is the proper lens.

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So the lens is essentially

loaded by my assistant

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on the table into this very

thin profile, like a scroll,

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and so it's smaller than

that two millimeter size.

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It goes in the eye like

a scroll, all rolled up,

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and then once it gets into your eye,

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your body temperature starts to heat up.

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Well, it doesn't.

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Your body temperature isn't hot.

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It's just hotter than the operating room.

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Once the lens goes into the eye,

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and your normal body temperature

starts to impact that lens,

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it then rolls and opens into

its own natural configuration,

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which is much larger, of

course, then that incision,

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and it has two little arms

that hold it out and stretch it

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and keep it in a centered

position where it should be.

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Most health insurance

covers cataract surgery

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for traditional lens replacement,

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but if you're willing

to spend a little more

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on out-of-pocket expenses,

you may be a candidate for

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one of two types of specialty lenses.

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The multiple focal lens

can give you both close-up

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and long distance vision,

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and the more common toric

lens can correct astigmatism.

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Patients who have large

levels of astigmatism

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who may have had to have worn

a contact or a rigid contact

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and gas-permeable, scleral

lens, things like that.

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Those patients are amazed,

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because they're out of their contacts.

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They've now corrected their astigmatism

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with something inside their eye

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and their distance vision is excellent.

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Now, they don't have near

vision with that lens,

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but many of them are okay with that.

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And they want what we refer

to as custom distance.

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They want the clear,

beautiful distance vision

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and they're okay having near vision.

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Some of them are okay

wearing glasses still

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with almost no correction

above, but with a bifocal below,

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and they just like the ability

to take those glasses off

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when they need to, to ski or do whatever,

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and still have great distance vision

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and put them on for their near work.

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With a multifocal,

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or what's called an enhanced

depth of field lens,

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you now bring in your world

much, much, much closer.

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You can pick up the things

in the grocery store,

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or read the price tag.

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You can read most things

that you need in your world.

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If you're doing something like tying flies

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or reading the fine print

on a pill bottle, well,

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you may need to put a pair

of readers on for fine work,

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but for most of your activity,

you're able to do that.

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These lenses work by essentially

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casting multiple images onto the retina,

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and your brain then

learns to ignore the image

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that's out of focus for the

given distance that you're in.

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Dr. Fenberg warns that patients

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who elect to have one

of the specialty lenses

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implanted in their eyes will

need to be evaluated first

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to ensure that they're a good candidate,

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both physically and emotionally.

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Adjusting to the new lenses can take time.

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I tell patients, we change

your visual system instantly

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when we do cataract surgery,

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and it takes some time to adapt to that.

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So if I go and get a new pair of glasses

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from my favorite local optometrist,

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no matter how well I actually

see when I put them on

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and they tell me I'm 20-20,

I'm still not adjusted yet.

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I don't like them initially,

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because the astigmatism

is a little different,

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and the focal point and the size,

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and it just takes a little bit to adapt,

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and so they always tell

you, you know, I'm sorry.

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You got to give it a couple

of weeks and see how you do

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before we make an adjustment.

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With surgery, we do that

permanently and instantly,

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and we take your patch off the next day,

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and for most patients,

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they're not quite certain

how great it is initially,

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but by a few days to a few

weeks, they're loving it.

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They are loving their

spectacle independence.

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If you'd like to know more

about cataract surgery

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and the options available to you,

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contact SWEyeConsultants.com.

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I'm Deborah Uroda for Healthy Living.

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