Frequently Asked Questions About Cataract Removal(click on a question to show/hide the awnser) Why do I need surgery?
Because cataracts develop slowly and usually in both eyes, you may not realize how much your vision has been affected. Once the lens in the eye becomes cloudy, hazy and discolored, the quality of your vision diminishes. This can affect reading, driving and your overall safety. By having your cataract removed, you can expect improved vision and return to your normal daily activities soon after.
Modern cataract and implant surgery is one of the miracles of modern medicine. Since its widespread adoption in the mid-1970s, hundreds of millions of operations have been performed worldwide. The great majority are successful and patients are pleased with their improved vision. We take all precautions to prevent post-operative complications such as infection, inflammation, swelling of the front or back of the eye, and increased pressure in the eye. Even if a complication occurs, most can be managed with little effect on the ultimate post-operative vision.
Light sedation is used to relax you and your eye is numbed with a local anesthetic. You may see a bright light and feel pressure in your eye as a small incision is made. The cataract is broken into small pieces and then removed. An intraocular lens implant (IOL) is used to replace your natural lens. Stitches are usually not required during the surgery.
State of the art cataract surgery is not painful. All precautions are taken to see that your experience is pleasant and comfortable. The surgeon will use an anesthetic material to numb the eye and you will be given light sedation to reduce the "butterflies".
The answer is "as long as it takes to do a safe and good job". On average, modern cataract surgery takes approximately 15-20 minutes of actual surgery time. If additional work is required - for example, additional surgery directed at managing glaucoma - the operating time will be longer.
Many implants are made of a material called acrylic. Other implant materials have been routinely and safely used for many years and have been exceptionally well tolerated by the tens of millions of patients that have undergone implant surgery.
Monovision is using one eye for near vision and the other for distance. Because implants cannot focus distance to near automatically as the young human lens can, it is necessary to "cheat" a little by assuring that one eye - usually a person's dominant eye - can see very well at distance without glasses and the second eye - the non-dominant eye - a little near-sighted so that the person can read regular printed material without glasses. Monovision is a method to reduce the need for glasses after surgery. But, glasses may still be required.
The eye loses its ability to focus both at distance and near after the age of 40. A multifocal lens is a form of implantable lens that is designed to help the cataract surgery patient recapture a portion of that ability. The goal of using a multifocal lens is to reduce the need for glasses for both distance vision and near vision post-operatively.
In some patients with astigmatism, we can perform additional measurements and reduce your astigmatism at the same time we remove your cataract. Your doctor will talk with you before surgery to see if you are a good candidate for this procedure.
Depending on the type of anesthesia used you may need to wear a patch and shield for approximately 2 to 4 hours after surgery. You will be asked to wear your shield at bedtime during the first week after surgery.
Based on research, the drops are designed to reduce the chance of post-operative infection. Also, the body will respond to the "controlled injury" of the surgery by initiating a process called inflammation. It is important to control the body's normal response to the surgery.
The hospital nurses and our technicians will review your medications and instructions with you. If you have difficulty getting drops into the eyes for physical reasons such as arthritis, please let us know. The most important thing is to use your drops consistently and as directed. To put in your drops, look up, pull your lower lid down and place one drop of medication in your lower lid. Some patients like to refrigerate their drops so they can feel them as they are put into the eye.
Minimal. You can bend, go out and resume most of your normal activities. No heavy lifting (over 30 pounds) and no strenuous exercise for the first 3 days after surgery. It is not advised that you touch or massage the eye in the immediate post-operative period. Protect the eye with glasses, sunglasses or shield when using machinery such as grass cutters and weed whackers. Avoid the potential of contamination. Never rinse the eye with tap water.
Although you will see "charges" from the hospital, the surgeon and the anesthesia group, your insurance will pay all parties an agreed-upon amount for the services rendered. You will be responsible for any co-payments, deductibles and non-covered amounts. These vary by insurance plan. You may wish to contact your plan prior to undergoing surgery to verify your responsibility. The surgeon's fees include 90 days of post-operative followup care at no additional charge.
Most patients will not depend upon their glasses to the same extent as they did pre-operatively. By measuring the shape and length of the eye, we are able to select an implant that provides good vision while decreasing the need for glasses. Not all implants can reproduce the young human len's ability to see both at a distance and at near. If you are active and enjoy sporting activities such as golf or drive a car, the implant will be selected to attempt a correction of your distance vision so that glasses may not be necessary. Although your distance vision may be excellent, you will still need some help with reading fine print.
We will prescribe new glasses for you at the time of the third post-operative visit, about one month after your surgery. Although it can be done sooner, we find the prescription stabilizes around the time of this third visit. If you decide to purchase your glasses in our optical shop, you can expect them to be ready about one week after placing your order.
Some patients may need to use interim reading glasses before the eye stabilizes and a final prescription can be written. Your doctor will help determine if these will be necessary at your post-operative visits.
The brain must interpret the images that the two eyes "see". If the post-operative eye sees very well and the unoperated, second eye does not, the brain will have difficulty "fusing" the images. Time generally improves this situation but "balancing" the vision in each eye so that they both see well is the ultimate goal. Surgery in the second eye often improves this problem.
In this country, we do not do surgery on both eyes at the same time. If you are comfortable with your first cataract surgery, we can do surgery on the second eye soon after the first eye. Usually, we will depend upon you to tell us when you wish to have the second eye done.
The most common reasons for poor vision following cataract surgery are conditions that affect the eye and existed before the operation. These might include such things as diabetic damage, macular degeneration, damage to the optic nerve because of poor circulation or glaucoma, previous injury, lazy eye or amblyopia. A small percentage occurs because of surgical complication but the surgical complication rate is one of the very smallest in medicine.
Our Surgical Care Coordinator, Andrea Lombardo, is available to address any other questions or concerns you may have about your surgery. You may email your questions to her using our contact form. Or, you may reach her by telephone at 330.247.2480.