Jul 24, 2014 — Advancements in the treatment of cataracts tailor the procedure to better fit individual patients. Dr. Craig Chaya from the Moran Eye Center talks about how these options can improve quality of life. He also gives some details about what promising technologies lie on the horizon.

Interview

Interviewer: If you have cataracts today, it could be a whole different treatment plan than it was 15 or 20 years ago. We'll examine that next on "The Scope".

Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You are listening to "The Scope".

Interviewer: It used to be there was one way to treat a cataract. Now there are a lot of different ways and it's actually very personalizable. We're going to find out more about that with Dr. Craig Chaya right now from the Moran Eye Center. Let's talk about some of the treatment options for cataracts because it used to be real simple. There was one thing that could be done. Now there are a lot of things. There are a lot of treatment options somebody might want to consider.

Dr. Craig Chaya: Right. For example, there are a lot of patients with cataracts that actually suffer from astigmatism as well. Astigmatism is a curvature issue with the cornea and often times that needs to be corrected in order for patients to have their best vision. Some of those options include glasses after cataract surgery or sometimes we can do some certain types of incisions that we can make on the cornea to make it more round and spherical, more regular shaped.

Interviewer: So actually while you're in there doing the surgery you might be able to do fix some of that other vision as well.

Dr. Craig Chaya: Correct. And now we've got these great lenses that not only reduce or eliminate the cataracts, but also help to reduce astigmatism at the same time, almost a two for one. And that really for the patient helps to reduce the dependence on glasses.

Interviewer: Yeah, so that's one treatment option. What are some of the other treatment options?

Dr. Craig Chaya: Some of the other treatment options are there are certain types of lenses that allow people to see both far away and up close without having to use glasses, really giving people independence from glasses and helping patients to be able to be more youthful so to speak in order to be able to enjoy their life, and not be so dependent on needing glasses for certain tasks. So those lenses are what we call multifocal lenses and those can be a benefit for the certain type of patient that's really motivated to want to get out of their glasses, and they are willing to accept that.

Interviewer: So kind of like bifocal lenses.

Dr. Craig Chaya: Correct, yeah.

Interviewer: Yeah.

Dr. Craig Chaya: We would call them multifocal lenses with this certain type of technology, so that's another advancement in technology that has been beneficial for many patients. Another one would be being able to just customize where we would put a lens. I can think of one patient particularly that loves to read in bed. And that person didn't want to have to read with glasses in bed. So for that particular patient I chose a lens that allowed that patient to see clearly while reading and then that person decided to have glasses to be able to see far away. So that choice was really an individual decision that I could not make for that person without having . . . hear them tell me what their hobbies were, what their expectations were before and after surgery.

Interviewer: So it sounds like you ask a lot of those types of questions now to make sure that it fits their lifestyle.

Dr. Craig Chaya: I think it's important. You have to, I think. Otherwise, patients are . . . You put them in a possibility of being disappointed after a cataract surgery and I've had some. And part of that has stirred me to be more informative preoperatively to ask patients, "What is it that you're expecting after cataract surgery? What is it that you desire with the lenses afterwards? And what are your hobbies? What are some things that you like to do? Ultimately many patients say, "Doctor, help me choose. I'm not sure what to do." But I think this conversation needs to take place ahead of time in order to be able to choose the appropriate lens for a patient.

Interviewer: So are there any other considerations when it comes to cataract procedures that somebody should be aware of?

Dr. Craig Chaya: Yes, in the several years there has been a new advancement in technology. Traditionally we've taken cataracts out by using ultrasound technology by breaking lens up into small pieces and then vacuuming it out, but now we have the assistance of using lasers. Lasers allow us to be a little bit more precise or actually a lot more precise than we can by our own hands. And lasers have been employed in cataract surgery to help soften the lens to make it easier to remove. So what would normally be a very difficult lens to remove in very challenging circumstances, laser cataract surgery may help us to make those changes and do those surgeries, and make them more routine and safer for the patient.

Interviewer: Yeah, a lot more safe.

Dr. Craig Chaya: Yeah.

Interviewer: What else is on the horizon that you're excited about?

Dr. Craig Chaya: Well, the Holy Grail is a lens that has excellent vision, both at the near and at far, and we're still waiting for that lens. We don't have one that has really met all the different criteria for an excellent lens that can focus up close and far away with no decrement and quality of vision.

Interviewer: Yeah, that's a challenge I'd imagine.

Dr. Craig Chaya: Yeah, and people are working hard at it. It is truly the Holy Grail of cataract surgery, so I think we're getting a lot closer than we were ten years ago though.

Interviewer: I don't know. I think the Holy Grail would be the Steve Austin bionic eye. I think that would be pretty neat.

Dr. Craig Chaya: X-ray vision, that would maybe be the next Holy Grail.

Interviewer: Yeah, do you have any final thoughts for somebody that's facing some cataract surgery? I think you gave some great points of consider what your hobbies are, consider what your lifestyle is. Anything else?

Dr. Craig Chaya: I think it's important for anybody that's undergoing cataract surgery or about to undergo cataract surgery to have a really deep conversation with their doctor to let them know what their expectations are because sometimes in a busy practice it may go unnoticed, or it maybe an issue where a doctor may assume that a patient wants a certain type of lens. But I think it's important for patients to know that there are options now. It's not a one size fits all. We really want to try to tailor make this cataract surgery for the individual.

Announcer: We're your daily dose of science, conversation, medicine. This is "The Scope", University of Utah Health Sciences Radio.


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