Proffitt Eye Center
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Cataracts

Sight is our most precious sense, enabling us to enjoy and function in the world we live in. In past centuries, the development of cataracts doomed a person to significant lifestyle limitations as well as, in some cases, eventual blindness.

Today's modern microsurgical techniques allow for a true modern day miracle, that restores sight to most cataract patients. It is no longer necessary to give up activities such as reading and driving due to cataracts.

One of Proffitt Eye Center's specialties is restoring sight to people whose eyesight has been impaired by cataracts. Over the past twenty years, Dr. Proffitt has performed over 15,000 cataract surgeries, using the most advanced surgical techniques and equipment. The techniques adopted by Dr. Proffitt meet or exceed standards of excellence and have attracted patients from across the state of Nebraska.

This technical excellence offered by Dr. Proffitt is combined with warm, personal care, making the cataract experience at Proffitt Eye Center pleasantly unique.

Setting New Standards In Cataract Surgery
Robert S. Proffitt, M.D., explains why going the extra mile is so important in health care, and why a staff that shares his philosophy surrounds him.

“Cataract surgeons have the unique opportunity of not only restoring vision, but also improving the quality of their patients’ lives by reducing dependency on glasses. In order to do this, we must exceed the acceptable standard of care.”

“I have adopted multiple techniques that have enabled Proffitt Eye Center to claim one of the lowest infection rates in the country. I feel this can be largely attributed to the precautions we take when performing surgery. A specially formulated solution of antibiotics is used during the surgery, as well as providing patients with topical antibiotic coverage preoperatively. Prevention of infection is critical, but so is providing accurate predictable results. Specialized measurements are obtained preoperatively with the Zeiss IOL Master to determine the correct ‘lens implant’ power for each eye. This critical information is entered into the latest formulas available to calculate the appropriate lens power."

“I realized early in my career that just meeting the standard wasn’t enough. Accepting the status quo wasn’t fair to my patients. I have been a part of the evolution and innovations in ophthalmology that make surgery safer, simpler, and a more pleasant and successful experience. Many of my cataract patients receive extra services that are not reimbursable. These are value-added services that raise the level of care by increasing the safety and success of an already safe procedure, thereby improving the quality of vision.”

How we see
The miraculous process of sight occurs when the eyes and the brain work in harmony to transform light images into sight. Light rays first pass through the transparent cornea, which focuses them through the pupil to the lens. The lens is made of a clear, flexible gel surrounded by the transparent lens capsule. When light rays reach the lens, it adjusts its shape to fine-focus the images onto the retina which covers the back of the eye. Once the retina has received the light images, it translates them into electrical impulses. The optic nerve carries these impulses to the visual cortex of the brain, where they are interpreted into sight.

When any part of the visual system is not working properly, the process of sight can be interrupted. One of the most common problems which can affect vision is a cataract. Almost everyone who lives a long life will eventually develop cataracts.

What is a cataract?
The term cataract is used to describe a natural lens which has turned cloudy, usually as part of the natural aging process. Cataracts are not a growth, a film, or a type of cancer. Light cannot pass through a cataract easily, so the retina only receives blurred and distorted images. The retina is then unable to send clear signals to the brain, and vision is gradually impaired. If cataracts are not removed, blindness can eventually result.

Cataracts develop for a number of reasons, but the most common cause is aging. Age-related cataracts develop as a result of natural changes within the lens. In other cases, an injury or blow to the eye may cause a traumatic cataract. Some cataracts may also result from the use of certain drugs, exposure to harmful chemicals, excessive amounts of ultraviolet radiation (UV rays), or some diseases. In addition, a small number of babies are born with congenital cataracts as a result of unusual prenatal factors. Very infrequently, cataracts can develop during childhood. Fortunately, almost all cataracts can be successfully removed and vision restored through modern microsurgery.

What are the symptoms?
Because cataracts form in different ways, the symptoms of cataracts are variable. Most people notice that their vision gradually deteriorates -- objects may begin to look yellow, hazy, blurred or distorted. Many people also find that they need more light to see clearly, or that they experience glare or halos from lights at night. Other common problems include increasing nearsightedness, double vision, or the appearance of dark spots or shadows in the vision. In advanced cases, the cataract may be visible as a white or yellow-looking pupil.

A Painless Surgery
Thanks to recent developments in anesthesia, cataract surgery is a painless experience. Only eyedrops or anesthetic gel are necessary to numb the eye. Topical anesthesia is used rather than painful and potentially dangerous needles and injections.

Modern Microsurgery
Modern cataract surgery begins with a very small incision. A special kind of incision, called a no-stitch incision, is generally used by Dr. Proffitt. These incisions are preferable, because they seal themselves immediately after surgery and heal over the following weeks. No stitches are used, and normal daily activities can be maintained during this period. Another advantage of no-stitch incisions is that they are less likely than other incisions to cause a focusing problem known as astigmatism. In fact, depending upon where the surgeon makes the incision, no-stitch incisions can actually reduce astigmatism which existed naturally before surgery.

After the incision has been made, the surgeon gently inserts a small instrument into the eye which is used to tear a small round opening, known as a capsulorhexis, in the lens capsule. Another instrument, called a phacoemulsification tip, is then inserted through this round opening. Phacoemulsification uses high-speed ultrasound waves, vibrating 40,000 times per second, to break the cataract into tiny pieces which are then gently suctioned out of the eye. This Ultrasound procedure is currently the most effective method for removing cataracts.

Once the cataract has been removed a lens implant is placed in the lens capsule to replace the focusing power of the natural lens. Lens implants are very small and are designed to fit permanently within the lens capsule, where they fulfill most of the functions of the natural lens. They are made of special materials which require no care and which will not be rejected by the eye. Lens implants come in different powers, as do glasses or contact lenses, and are selected to improve the eye's focusing ability.

Many people discover that lens implants improve their vision and give them greater freedom from their glasses than they enjoyed before they developed cataracts.

Lens implants (Premium IOL's) that correct for or reduce the eye's astigmatism are called Toric IOL's and are extremely successful.

After your surgery
A cataract operation is relatively brief -- usually lasting between 10 and 12 minutes. Once the surgery has been completed at the ambulatory surgery center, the patient is escorted into the recovery area. After being monitored by a nurse and receiving some simple instructions on eye care, people are free to leave. Most people appreciate being able to resume their regular activities soon after surgery.

The risks and benefits
Fortunately, cataract surgeries performed by Proffitt Eye Center's surgeons are highly successful procedures. In general, the few complications which exist with cataract surgeries are becoming even more unlikely with new developments in surgical techniques.

The very rare complication rate associated with cataract surgery is more than offset by the excellent results. Eye diseases or problems with the retina or optic nerve may limit the potential for clear vision even when the cataract surgery itself has been successful. At Proffitt Eye Center, over 99 percent of cataract surgery patients enjoy good vision after their surgeries, when no other serious eye problems existed before the surgery.

Furthermore, there are numerous benefits of cataract surgery, many of which cannot be measured. These include:

Questions and Answers

Must someone accompany me on the day of surgery?
Yes, it is necessary that another capable individual drive you to and from the surgery center on the day of surgery and to our office the following morning for your first post-operative visit.

What should I bring with me the day of surgery?
The following is a list of things we recommend you bring:

I take several other prescription medications. Should I continue these before surgery?
Yes, take all prescription medications as you normally would before surgery unless told otherwise. In many cases some blood thinners will be discontinued for several days prior to surgery, your physician will help with this decision.

I am a contact lens wearer. May I wear my contacts until the day of surgery?
No, contact lens wear should be discontinued at least 1-4 weeks prior to your scheduled cataract surgery. Please follow your surgeons recommendations.

May I eat before surgery?
No. The anesthesia department at the surgery center recommends you don’t eat or drink anything for six hours prior to your surgery, other than a small amount of water to take your routine medications.

May I wear makeup on the day of surgery?
No, please don’t wear ANY makeup on the day of surgery.

I’m on oxygen. Should I bring it along?
Yes, bring your oxygen with you. However, oxygen is available at the surgery center and you will be given oxygen during your short surgical procedure.

Surgical Questions

Will I have any pain or feel anything during surgery?
No, you will not experience any pain or discomfort during the surgery. Most patients feel only gentle pressure at most.

Would a cough prevent me from having surgery?
In most cases, no. It is very important that you don’t cough unexpectedly during surgery. Please warn the surgeon prior to coughing during the surgical procedure.

Will I be given any medication to sedate me during surgery?
In most cases yes, however it isn’t required. Most patients do request some medication to help them relax, but you won’t be put to sleep for this surgical procedure.

Will I need to have blood drawn prior to surgery?
No, unless there is a specific indication such as for blood sugar testing.

Do I need to take antibiotics prior to eye surgery like I do before dental surgery?
Dr. Proffitt works in a sterile environment, it is unlikely that you will need to take antibiotics prior to cataract surgery. Please contact your physician if you have questions regarding this subject.

How soon may I leave the surgery center following my surgery?
In most cases, patients may leave within 30 minutes following the surgical procedure.

How soon may I have cataract surgery performed on my other eye?
As soon as one week apart, assuming the first eye is doing well postoperatively and the other eye requires cataract surgery.

May I drive myself home?
No, it is strongly recommended that you don’t drive the day of surgery due to the sedation and possible blurred vision for the first day following surgery.

Do I need a physical before surgery?
Not in most cases. The surgery center’s anesthesia department will perform a pre-operative evaluation prior to proceeding with the surgical procedure.

Post-Operative Questions

Did I have a lens implant as well as having a cataract removed?
Yes, the lens is responsible for a significant portion of the eye’s focusing power and so it must be replaced with a lens implant in order for you to see clearly. Lens implants are required following cataract surgery except in cases of extreme nearsightedness. If a lens implant weren’t placed in the eye at the time of surgery, thick “cataract glasses” or a contact lens would be necessary.

Of what is my implant made?
Most implants used by Dr. Proffitt are acrylic.

How long will my implant last?
The intraocular lens implant is placed permanently in your eye and won’t wear out.

Can my eye reject the lens implant?
No, since the intraocular lens isn’t made of human tissue your body can’t reject it.

Was a laser used to remove my cataract?
No, your cataract was removed by ultrasound not laser. The process is called phacoemulsification where ultrasound is used to gently break up the cataract so that it can be removed from the eye. Lasers are being developed to remove cataracts, however ultrasound is much more efficient at this point in time.

Can I wear my old glasses after surgery?
Wearing your old glasses won’t harm your eyes, but since the old lens prescription is no longer best for the eye that had surgery you will probably see better without them. Most people find it necessary to wear reading glasses only.

Is it safe to resume activities I enjoy such as golf and walking following surgery?
Yes, we encourage you to resume normal activities within days of your surgery. Normal activities such as lifting and bending won’t harm your surgery.

How soon may I resume driving after surgery?
Most patients enjoy a significant improvement in their sight within the first 24 to 48 hours. You may drive when you feel comfortable and safe in your visual function for this activity.

May I wear makeup following cataract surgery?
Yes, you may wear makeup on your face such as lipstick and powder immediately after surgery, however eye makeup should be avoided for the first 10 to 14 days.

Is it safe to have my hair done or get a permanent following cataract surgery?
Yes, just like before cataract surgery you should avoid any chemical contact with your eyes and take sensible precautions.

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