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Refractive Cataract Surgery

Premium IOLs (“Flex-Sight” Lenses)

Refractive cataract surgery is a relatively new term, used to describe the merging or combination of traditional cataract surgery with modern refractive surgery techniques.

In the past, the goal of cataract surgery was more purely medical and restorative. The surgery was performed when it was medically necessary to remove a cloudy lens in order to restore a person’s ability to see (usually with the aid of eyeglasses or contact lenses after surgery.)

Refractive cataract surgery has a more aggressive goal: To enable the person who has cataracts to regain good vision and to eliminate or greatly reduce their need for corrective eyewear, including reading glasses, after surgery.

At Singer Haley Vision we use the best technology to accomplish this goal. Please read below to learn about cataracts, as well as the latest technology to treat them. Our Metairie based ambulatory surgery center is the only surgery center to have the ORA system for which allows for practically perfect Intra-ocular lens power calculation. We are so confident of our results that we offer free LASIK fine tunings if the results are not what we expected.

What is a cataract?

A cataract is the clouding of the lens of the eye. Normally, light passes through the clear lens and is focused onto the retina. However, as a result of the natural aging process, the lens gradually becomes cloudy. The cataract or cloudy lens blocks the passage of light through the eye and causes distorted or blurred vision.

How Do Cataracts Form?

Cataracts form when your natural lens loses its elasticity and hardens. This is a natural process, which is why aging is the number one cause of cataracts.

What are the beginning signs of cataracts?

Gradual blurring of your vision always accompanies developing cataracts. You may also experience glare in bright light or colors may begin to fade. Cataracts do not cause pain or sudden vision loss.

How Are Cataracts Treated?

Surgical removal of the cataract and the implementation of an artificial lens is the only treatment for a cataract. However, technological advances have afforded patients with the restoration of their vision.

During cataract surgery, the clouded natural lens is dissolved and replaced with a plastic foldable intraocular lens (IOL). The IOL’s used over the last 30 years are called standard monofocal IOL’s because their focus is set to provide distance or near vision, but not both. Patients who receive a standard monofocal IOL usually still need to wear glasses to achieve the clearest focus for distance and near objects because of astigmatism or presbyopia.


About half of the population is born with corneas that are shaped in a way which create astigmatism. If you have astigmatism, and you want to see clearly in the distance, you need to wear glasses or contact lenses. Recently, a new style of IOL called a toric IOL was introduced. The toric IOL can partially correct, or at least partially correct your naturally occurring corneal astigmatism so you won’t be so dependent of glasses to see in the distance after cataract surgery.


With time, almost everyone is affected by presbyopia. Presbyopia is a part of the normal aging process and happens to all of us. Presbyopia is caused by the loss of flexibility of the natural lens and the weakening of the lens’s focusing muscle. It becomes evident to most of us at about the age 45 and that’s why we have to start wearing reading glasses or need to begin wearing bifocals. We just can’t see up close without them. Everyone who undergoes cataract surgery with a standard monofocal IOL needs to have reading glasses to see up close afterward because presbyopia is not treated by the standard monofocal IOL. But over the past few years, there have been several IOL’s introduced which correct presbyopia after cataract surgery. Patients who choose one of these presbyopia correcting IOL’s can usually see far away and up close without glasses. We call these the “Flex-Sight” lenses because they allow flexible vision, i.e., distance, intermediate, and near.

Premium IOLs

The introduction of new premium intraocular lenses (IOLs) has been key to the development of refractive cataract surgery. These premium IOLs have the capability of providing good uncorrected visual acuity at all distances after cataract surgery, eliminating or reducing the need for eyeglasses after surgery.

Types of Premium IOLs

The types of premium IOLs currently used for refractive cataract surgery include:

Toric IOLs

Toric IOLs correct astigmatism. Residual astigmatism is a primary reason why people still need to wear eyeglasses after conventional cataract surgery. With toric IOLs, the surgeon can select a lens power that corrects pre-operative astigmatism for a better chance of 20/20 uncorrected visual acuity after surgery.

Presbyopia-Correcting IOLs

Sometimes after age 40, nearly everyone loses the ability to see clearly up close due to an aging change in the eye called presbyopia.

Even young people who sustain a cataract before becoming presbyopic lose this near focusing ability after conventional cataract surgery. This is because, unlike a young natural lens, traditional IOLs are inflexible and don’t have the ability to change shape to focus light for near vision.

Today, premium IOLs have been developed to correct presbyopia and restore near vision. There currently are two types of presbyopia-correcting IOLs: accommodating IOLs (Bausch & Lomb’s Crystalens) and multifocal IOLs (Alcon’s AcrySof ReSTOR diffractive IOL and AMO’s Tecnis multifocal refractive IOL).

At our Center, we focus on the multifocal IOL’s (“Flex-Sight” lenses). We rarely use Crystalens, numerous studies have shown that it is not very helpful in allowing patients to eliminate the need for reading glasses. The multifocal IOL’s have a much higher rate of success and patient satisfaction.

ORA System (Optiwave Refractive Analysis)

Just when you thought technology couldn’t get any better, we now offer a new cataract surgery measurement tool which helps customize your vision even further during cataract surgery. The ORA intraoperative aberrometry system provides real-time analysis of your eye during surgery. Before ORA, there were no available tools like this. Prior to cataract surgery, other measurements are taken to ensure proper IOL or intraocular lens power selection but there was always a margin of error when making the proper selection. Surgeons are unable to assess quality of vision during the cataract procedure and would need to wait weeks to determine if the proper IOL selection was made. With this new technology, verification of the proper IOL happens during your surgery.

This is extremely useful in patients who have had previous refractive surgery (RK, LASIK, or PRK), since their natural corneal shape has been altered, and standard formulas to calculate proper IOL power cannot accurately account for this change. It is also very helpful in patients who have had certain types of retinal surgery, which can change the length of the eye and therefore affect the accuracy of the IOL power.

There is only one ORA system in the New Orleans are and we use it at Singer Haley Vision.


Cataract Eye Surgery | Singer Haley Vision: Louisiana LASIK & Cataract Surgery Leaders


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4720 S. I-10 Service Road, Suite 406, Metairie, LA 70001, Phone: (504) 456-3155, Fax: 504-456-3113
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