During standard cataract surgery, called phacoemulsification (phaco), a 3.5 mm corneal incision is made.

An ultrasound instrument is introduced into the eye and used to break the cataract up into small fragments, which are then removed.

A standard foldable artificial lens is inserted in the eye to replace the clouded natural lens. After standard cataract surgery, you will have to wear glasses to improve your vision.

Custom cataract surgery

Also called refractive cataract surgery, custom cataract surgery has two main advantages over standard surgery:

1. A smaller 2.8mm incision
2. Most vision problems are corrected during the surgery.

In recent years, new emerging techniques and technologies have made custom cataract refractive surgery a safer procedure, with shorter recovery time, less risk of complications and, above all, more predictable visual outcomes.

Variable phaco

This new technology produces little or no heat, thus eliminating the burning of corneal tissue at the incision and accelerating the healing process.

In 2004, The Montreal Eye Clinic acquired the variable White Star technology. It allows the surgeon to adjust the power and speed of the machine, depending on the cataract condition and the fragility of the eye.

These new options enhance the safety of the surgery and improve the visual outcome.

Correction of myopia and hyperopia

Using laser biometry, multiple eye measurements are taken to calculate the power of the lens to be implanted into the eye. In most patients, myopia and hyperopia can be partially or totally corrected.

Normal vision
Light rays pass through the cornea and focus on the retina. Both distant and close objects appear clear.

Myopia
Myopia occurs when the eyeball is too long. Light rays focus in front of the retina and distant objects appear blurred.

Hyperopia
In this case, the eyeball is too short. Light rays focus behind the retina and close objects appear blurred.

Correction of astigmatism

With astigmatism, the curve of the cornea is irregular. Light rays focus at multiple points and both distance and close visions are blurred.

The astigmatism can be corrected surgically using the astigmatome or by implanting a toric lens. If the astigmatism is high, it may be corrected by Excimer laser.

1. Astigmatome
   Guided by the topographic map, this new instrument makes accurate microsurgical corneal cuts of precisely calculated length and depth, in order to reduce astigmatism.
2. The Excimer Laser

Improving Functional Vision

As the eye begins to age, the lens is less able to focus light on the retina. Because of this, the light hits a bigger section of the retina, resulting in reduced contrast sensitivity. The image appears to be less sharp. Contrast sensitivity allows you to see the difference between shades of the same colors.

Functional vision is the vision that allows you to function properly in different light conditions. It is proportionally related to contrast sensitivity. The higher the contrast sensitivity, the better the functional vision.

Two new intraocular lenses (IOL), the clear IOL and the modified IOL, can provide better functional vision. Because of their new square edge design, there is less likelihood of developing secondary cataracts.

Clear IOL
The new anti-glare concept, available only in second generation intraocular lenses, allows full light transmission for uncompromised color vision. Because of its square edge design and its glare reduction effect, night vision is improved. For more information on the lens: Clariflex™

Modified IOL
This new IOL can also correct some of the subtle optical imperfections (higher order aberrations), to further improve contrast sensitivity and functional vision. It has a modified surface, unique among intraocular lenses, which was developed based on wavefront aberration analyses of human corneas. For more information on the lens: Tecnis™

Correction Presbyobia

What is presbyopia?

The natural lens of the eye hardens with age, preventing the eye from focusing accurately.  This marks the onset of presbyopia, which progresses over the years, requiring people over the age of 40 to wear bifocals or reading glasses.

Multifunctional IOL
Most cataract patients also have presbyopia. During cataract refractive surgery, a multifunctional lens could be implanted in the eye. This lens is also called a multifocal lens because it has small magnification rings that allow you to have a full range of vision without glasses at all distances: far, mid-range and up close.

With the multifocal IOL, night driving vision may be reduced by halos and glare. These problems are related to the design of the lens and cannot be completely eliminated. However, in most patients, gradual improvement is noted in the months following surgery. For optimal results, multifocal lenses should be implanted in both eyes.

It is important to understand that the aim of using the multifunctional lens is not to eliminate glasses, but rather to allow you to do most of your daily activities without glasses. For more information on the types of lenses:

• ReZoom™
• Tecnis Multifocal
• ReSTOR™