Traditional Cataract Surgery involves the replacement of the natural lens with a standard monofocal lens. These standard lens implants do not support correction of astigmatism or improving vision at multiple distances, so glasses and/or contacts will still be required post-surgery when those conditions exist.
Long ago, cataract surgery was considered somewhat risky, and required a lengthy hospital stay. Many times the surgery was even postponed until the “cataract got ripe”, but that is no longer the case today. Todays’ technologies and resulting success has made this the most commonly performed surgery in the U.S.
Cataract Surgery: What to Expect
Cataracts will not grow back after they have been removed, but some patients do experience a clouding of vision months after surgery that feels very similar to cataracts. This is usually a sign of Posterior Capsular Opacification, which is the clouding of the capsular bag (thin tissue that holds the intra-ocular lens). In these cases, a Posterior Capsulotomy is normally done to painlessly open the clouded capsule to restore clear vision.
As for results, individual vision outcomes are largely dependent on the particular lens implants chosen at the time of surgery. Please visit our Intraocular Lens Implants (IOLs) page to learn more.
Cataract Surgery: The Procedure
BEFORE CATARACT SURGERY DAY:
You will undergo a Comprehensive Eye Exam to evaluate both the Cataract and the general health of your eyes. Expect the exam to last 1 1/2 to 2 hours, and it WILL include dilation of the pupil.
During the exam, special measurements will be taken of your eyes, and you will likely be asked to watch a video about Cataract Surgery. During this evaluation you will also learn about the specifics of your Cataract Surgery, including pricing, insurance coverage, any expected out-of-pocket costs, along with your available lens options. You should also be prepared to provide us with your lens selection at this time.
Once your surgery is scheduled, 2 days prior you will begin using prescription eyedrops (normally antibiotic and anti-inflammatory) in preparation for the surgery.
Note: In some cases, the doctor may request a consultation with your Primary Care doctor for a Medical evaluation, Clearance and an EKG before scheduling your cataract surgery.
CATARACT SURGERY DAY PREP:
Plan to arrive at the surgery center 1-2 hours prior to the procedure, depending on your particular situation. Patients who are having their second eye done will require less pre-opt time and only a quick exam for the operative eye. Other patients will require a more complete eye exam if they haven’t been seen at the surgery center prior.
Once checked in to the surgery center, the team will review your medical history before you are ready to be prepped for surgery. During this time, you may be offered a sedative to help you relax.
Once seated, area around your eyes are cleaned before a sterile drape is applied around them. Eye drops (a local anesthetic) will them be administered to prevent any discomfort during the procedure. Once your eyes are completely numb, an eyelid holder will be applied to prevent blinking during the procedure (called a lid speculum).
It is normal for patients to spend a total of 3 to 4 hours at the surgery center. And please note, you must bring a driver the day of your surgery, or your surgery may be cancelled.
A small incision will be made so the the cataract can be broken into microscopic particles using high-energy sound waves using a tiny Ultrasound probe. This process is called phacoemulsification, and is the latest FDA approved method for removing Cataracts.
This type of micro-incision is self-sealing, very rarely requires stitches, and is known to provide a very comfortable recuperation. This is due to the fact that the incision is not only fast healing, but the natural outward pressure within the eye is normally enough to hold things in place.
After the Cataract has been broken up, the microscopic lens particles are gently suctioned away before a folded intra-ocular lens (IOL) is inserted through the micro-incision, unfolded, and locked into place. To complete the surgery, special eye drops are applied and the eyelid holders and drapes are removed.
- Cataract Surgery Options for Astigmatism
- If you have a pre-existing astigmatism, you will likely have the option of a TORIC IOL, which specifically works to correct astigmatism. There is an extra charge for this lens which will not be covered by your insurance provider.
- Alternatively, the surgeon can sometimes place the surgery incision to reduce small amounts of astigmatism. It may also be possible to make a number of micro-incisions in the cornea to reduce the astigmatism. These small incisions are called LRIs (Limbal Relaxing Incisions), which can be performed manually or with our LenSx Femtosecond Laser. Just note, manual LRI procedure results aren’t nearly as predictable in comparison to LRIs using the LenSx laser or Toric IOLs.
- Cataract Surgery Options for Nearsightedness or Farsightedness
- New multifocal and accommodating IOLs offer the possibility of quality vision at more than one distance, without the need for glasses or contacts. Examples of these multifocal IOLs include different versions of Alcon’s Acrysof® ReStor® Lens Implant, Bausch & Lomb’s Crystalens Multifocal IOL, and Abbott Medical Optics’ ReZoom™ Multifocal IOL and TECNIS® Multifocal IOL.
AFTER CATARACT SURGERY:
Most patients will undergo a 20 minute stay in the recovery area while they receive instructions regarding care for their eye. Everyone heals at different rates, but everyone is sent home to relax for the rest of the day. Most patients are able to return to their normal activities within a day or two, the only limitation being heavy lifting.
In most cases, patients are able to see their referring Doctor of Optometry for the 1 day post-op exam, as well as for the 1 week and 1 month follow-ups. Although, an insurance provider will occasionally require post-operative care be done at the surgery center.
The following is also very common after Cataract Surgery:
- First 5-7 days post-surgery:
* Patients experience a gradual visual improvement as the eye adjusts
- First 2 weeks following surgery:
* Using eyedrops (antibiotic, anti-inflammatory, and steroid) several times a day will be required
* Wearing protective shield at night or during sleep will be required
* Wearing protective glasses during the daytime will be recommended
- First 2 months following surgery:
* Patients must avoid rubbing the eye
Note: Glasses or contact prescriptions are changed at the appropriate time by your optometrist, so remember, you should never drive yourself until you have confirmed your vision meets or exceeds the minimum legal requirements.
Please visit our Intraocular Lens Implants (IOLs) page to learn more about your Cataract Surgery replacement lens options.