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Cataract Surgery: A Bargain, Despite the Price
Date:9/23/2007

, professor and chairman of the Institute of Ophthalmology and Visual Science in New Jersey.

"During the past quarter century, there have been remarkable advances," Zarbin said. "Ninety-five percent of patients report impressive improvement in their vision."

Most cataract surgery removes the lens through phacoemulsification, in which a probe inserted through a small incision in the side of the cornea breaks the lens into tiny pieces using ultrasonic waves. The surgeon then removes the pieces using suction.

This technique has gone through countless refinements, Zarbin said, and is far evolved from traditional cataract surgery. In that procedure, the lens was simply cut away.

"Back in the 1960s, people were kept in the hospital for two weeks following cataract surgery," he said. "Their heads were held in place with sandbags. Now, people have the surgery with topical anesthesia and go home the same day. It's just what you'd hope for in medicine. It's really true progress."

The replacement lenses are also improving.

In early days, patients were fitted with a lens that only provided one range of focus. Near could be in focus, or far, but not both.

But improvements in intraocular lenses are producing results that are coming closer and closer to mimicking the human eye, allowing people to change their focus from near to far.

"There's a real push to develop intraocular lenses that give people focus at distance and near," Zarbin said. "There's a real interest in improving those capabilities. I'm very sure that one day that's the lens that everyone will get, an accommodative lens."

These improvements mean that, even though more money is being spent on cataract surgery, the American people are getting a bigger bang for their buck, Rein said.

"Compare the cost for cataract extraction surgery to the treatments that address age-related macular degeneration or diabetic retinopathy,"
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