Cataract Surgery

Ultrasonic phacoemulsification is the “gold standard” for cataract surgery. In phacoemulsification surgery, a small ultrasonic probe is inserted into a very small incision on the edge of the eye. This probe gently breaks the cloudy lens into tiny pieces and suctions the cataract out of the eye.

The Centurion offers a new method that uses both ultrasound and mechanical oscillation to help break up the cataract faster, and allows the surgeon greater control of lens tissue than traditional ultrasound.

Dr. Briana Brunner offers no-stitch, small incision cataract surgery to residents of Carroll County and surrounding areas using the new Centurion system. This advanced procedure holds several benefits over conventional forms of cataract surgery. With the no-stitch procedure, patients experience less discomfort, recover more quickly, achieve improved vision more rapidly, and are less likely to incur surgically induced astigmatism than with other forms of cataract surgery.

The Procedure

Dr. Brunner begins the procedure by applying a local anesthetic to the eye. There is no injection. A small incision, about 1/6 of an inch wide, is then made in the sclera (the white portion of the eye). The cloudy cataract lens is dissolved using the Alcon Infiniti Phacoemulsificator. After the cataract is removed, a folded intra-ocular lens (IOL) is inserted through the micro-incision, then unfolded and locked into permanent position. The small incision is self-sealing and usually requires no stitches. This type of incision heals quickly and provides a much more comfortable recuperation. The new lens will restore the function of a healthy, natural lens. The entire procedure lasts around 12 minutes, and because of the way the incision is made, the eye can heal without the need for stitches.

Standard Cataract Surgery includes the placement of a standard lens implant to restore brightness, color and clarity to images degraded by slow, progressive cataract formation. This procedure enables you to see distance, but reading glasses or glasses to correct astigmatism will still be required.

Advanced Refractive Cataract Surgery includes special lens implants and refractive technology to restore distance, near and intermediate distance. Designed to mimic the eye’s natural ability to focus on distant, middle and near objects, new lens-implant technologies are used in conjunction with standard cataract extraction methods to help restore a full range of functional vision, from distance to reading vision with total independence from glasses or contact lenses in most cases. Most patients can see to shop, read newspapers and use computers without depending on glasses following surgery. Advanced Refractive Cataract Surgery is an excellent investment in your vision.

Dr. Brunner and Carroll Vision Center are also pleased to be the first in Carroll County to offer Dropless Cataract Surgery, which helps eliminate the need for drops before and after your procedure. It is a safe and efficient approach, which patients find to be less expensive and more convenient. We will review all of these options with you and determine the best fit for your specific needs when you come in for your evaluation.

After Your Surgery

Because there are no needles or injections, only a tiny incision, stitches and an eye patch are not required after the surgery. In most cases, the incision is so small that the eye heals rapidly, with little or no discomfort, and the patient experiences a quick visual recovery. Patients can typically return to normal activities within a week. The following video describes some symptoms patients may experience directly after their cataract surgery.

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Approximately 21 million American adults have cataracts – a progressive clouding of the lens that can lead to loss of vision. Dr. Briana Brunner is a board-certified and fellowship-trained ophthalmologist at Carroll Vision Center, who specializes in cataract surgery using premium lens implants and advanced laser diagnostic imaging to achieve truly superior results for her cataract patients.

Carroll Vision Center's History With Cataract Surgery

In 1993, our very own Dr. Andrew Kessler became the first surgeon in Carroll County to perform refractive surgery. He began performing Laser Vision Correction after it was FDA approved in November 1995. Since 1993, he successfully performed thousands of cataract surgery procedures. He was the first surgeon to perform stitchless, small incision cataract surgery at Carroll Hospital Center. In July 2005, he became the first surgeon in Carroll County to implant the ReSTOR multifocal lens and offer laser assisted cataract surgery with the Alcon Lensx laser. He was also the first surgeon in Carroll County to offer Dropless Cataract Surgery. Dr. Kessler retired from clinical and surgical practice in December 2023, but worked closely with Dr. Brunner during the months leading up to his retirement. He hand selected her as his replacement and is looking forward to seeing all that she can accomplish for the residents of Carroll County!

Modern cataract surgery always includes a lens implant. This is an artificial lens (usually made of a soft acrylic) that restores the proper focus to the eye after cataract surgery. Until 2005 all lens implants were monofocal or single-vision lenses. Glasses were still needed after cataract surgery. Usually the glasses had an anti-reflective coating to assist vision in low light conditions. Today we have new advanced technology monofocal and multifocal (distance and near vision) lenses.

Dr. Brunner's goal with your cataract surgery is to give you the best possible vision you can obtain. The information below is to help you understand your options with lens implants. There are also additional services, which Dr. Brunner can perform to improve your vision by customizing your cataract surgery to your eye’s specific needs. She will be happy to discuss these options with you during your next visit to our office.

• The Standard Monifocal Lens is a basic, good quality, foldable lens.
• New Technology Monofocal lenses are computer designed and termed aspheric (slightly flatter in the periphery of the lens compared to the center of the lens). Aspheric lenses improve contrast sensitivity and reduce glare. This means that patients who have these lenses will have improved ability to see in varying light conditions such as rain, snow, fog, twilight, and nighttime darkness. The approval was based on a clinical study that measured night driving performance in cataract surgery patients. The lenses tested enables quicker reaction time and showed a meaningful safety benefit for elderly drivers.
• Astigmatism Correcting Lens. The Clareon Toric is a lens that is designed to reduce astigmatism and will substantially improve vision without glasses. This is the best choice to correct astigmatism and will give those patients who have significant astigmatism their best possible vision. Astigmatism means the shape of your eye is more curved than what it should be, causing your vision to be out of focus (squinting in the distnace to tell the difference between a "C" from a "G").
• New Technology Multifocal lenses are the state of the art in lens implants. The multifocal lenses offer the possibility of seeing well at more than one distance, without glasses. It is like having a bifocal lens inside of your eye. Most people with multifocal lens implants do not require glasses for distance or midrange and depending on the multifocal lens type, may not require glasses for most near tasks. Dr. Brunner uses the Alcon Vivity® Extended Depth of Focus Lens (EDOF) and the Alcon Panoptix® Trifocal lens. 

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Medicare and most insurance plans cover the costs for cataract surgery with single-focus lenses, with an additional charge for multifocal and toric lenses. Patients find the extra expense for well worth the exchange for freedom from glasses or contacts. Other payment options you can consider include:

• Flexible Spending Accounts (FSA): You can save up to 30% by using tax-free dollars to pay for your cataract surgery. Many employers offer an FSA or Health Savings Account.
• Financing: Carroll Vision Center is pleased to offer up to 24 months interest-free through CareCredit. 
• Credit Cards: Many patients opt to pay for their procedure using a personal credit card. This may be a good option, especially if you have a card that carries a low interest rate or offers points and other rewards.

Contact us today if you have any questions about these payment options.

What is a Cataract?

A cataract is a progressive clouding of the eye’s natural lens. It interferes with light passing through the eye to the retina. Aging and other factors cause proteins in the eye’s lens to clump together forming these cloudy areas. Early changes may not disturb vision, but over time cataracts typically result in blurred or fuzzy vision and sensitivity to light. People with progressed cataracts often say they feel as if they’re looking through a waterfall or a piece of wax paper.

What Causes Cataracts?

Cataracts are usually a normal part of the aging process. Cataracts typically develop by the time a person reaches his or her 60s or 70s, although they can occur at younger ages or may exist at birth. Other cataract causes can include eye trauma, inflammation in the eye, or diabetes. Cataracts usually develop in both eyes, but they may develop at different rates. Cataracts interfere with vision by scattering light as it passes through the eye to the retina

People commonly misunderstand a cataract to be a “skin” on the eye that must be “peeled off.” A cataract is not a growth, but a normally clear lens inside the eye that has turned cloudy.This cloudiness causes blurred images, loss of contrast, glare, or starbursts.

Is Cataract Surgery Effective?

Yes! Many patients report vision that is even better than before they developed cataracts. Modern cataract surgery is considered one of the most effective medical procedures used today. And these results are permanent. Once removed, the cataract won’t reoccur.

Over time, the lens implant can develop a "film" behind it, which can again cause symptoms of blurred vision. A simple laser capsulotomy procedure can be performed to create an opening in the film in order to restore normal vision. Laser capsulotomy does not require going to the operating room nor does it involve any incision into the eye. It only takes a few minutes and is painless. 

Where is Cataract Surgery Performed?

Your cataract procedure is performed on an outpatient basis and takes only a few minutes In most cases patients can resume daily activities such as driving or reading, almost immediately.

Does Insurance Cover Cataract Surgery?

Yes. Medicare and most insurance plans cover approved cataract surgeries. There is an additional charge for advanced technology lenses. Our staff will review all of this information with you.