When a person’s vision is blurred from cataracts to the extent that one cannot go about his or her normal daily activities, surgery would be recommended. The cataract or cloudy lens would be extracted surgically using ultrasound and a clear foldable implant would be inserted inside the eye. This entire procedure is done through a micro incision while the patient is awake. Topical anesthetic drops are put in the eye pre-operatively so there is no pain or discomfort with the procedure. The surgery is performed on an outpatient basis at Northwest Community Hospital Day Surgery Center and the entire process takes approximately two to three hours. The actual surgery takes less than 15 minutes.
What preparation do I need?
You should inform your internist or family physician that you are having surgery. In most cases nothing needs to be done. It is not necessary to discontinue any of your medications including aspirin or other blood thinners you may be taking. The surgery is usually done with the patient awake, although an oral sedative may be given pre-operatively to relax the patient or a light intravenous anesthesia may be administered by an anesthesiologist. Because of the sedation you cannot drive home from the hospital. However, under most circumstances, you can drive the following day. Several weeks prior to surgery you will be prescribed several eye drops to use starting two days prior to surgery.
What happens the day of surgery?
You will need to arrive at the hospital approximately 1-1/2 hours prior to your surgery time. The nurse will review your medical history and confirm the correct eye for surgery. A sedative will be given and eye drops will be placed in your eye to dilate the pupil. At the time for surgery, you will be wheeled into the operating room and numbing drops will be instilled in your eye. There are no shots or injections. During the procedure you will see a bright light but will not see the actual surgery being performed. At the conclusion of the surgery a clear plastic shield will be taped in place over your eye for protection. You will be discharged when you are stable and instructed to go home and rest the remainder of the day.
What happens after surgery?
The next day you will need to be seen in the office. You can usually drive to that visit. The eye drops you started before surgery will be continued for several more weeks. One week after surgery you will be examined and at that time given a new prescription for glasses. If you were scheduled to have cataract surgery on your second eye, which typically is about two weeks apart from the first surgery, the new glasses prescription would not be given until one week after the second surgery.
What are the risks?
There are approximately 14.2 million cataract surgeries performed yearly in the United States. Cataract surgery is very safe with serious complications occurring less than one in a hundred. But complications could occur and surgery should not be done unless you are having difficulty performing your daily activities such as driving or reading. Complications, although rare, include retinal detachment, corneal swelling, bleeding and infection.
CATARACT SURGERY OPTIONS
As you prepare for your cataract surgery, your surgeon may present options for you to consider. You may have a choice of the type of intraocular lens (IOL) that is inserted in your eye as well as the choice of the type of technology that is used to perform the surgery. The following describes the types of IOL available as well as an explaination of the laser-assisted cataract surgery that is now available. Your surgeon will discuss these options with you.
Standard Single Vision IOL - This is the most commonly used IOL and is covered by Medicare and all insurance companies. You can choose if you want your vision to be "set" for distance or for near. You will probably need to wear glasses afterward for distance and/or reading.
Astigmatism-Correcting IOL (Toric) - If you have been told you have astigmatism and want to be less dependent on glasses following surgery, this is the lens to consider. If you opt for this lens the surgery would be performed in conjunction with the LenSx femtosecond laser. Since this lens option is considered "deluxe", it is not covered by Medicare or insurance companies.
Multi-Focal IOL - If you would like better distance, middle and near vision and be less dependent on glasses following surgery, this IOL would be an option. If you elect to use the multi-focal IOL, the surgery will be performed in conjunction with the LenSx laser. This lens options is not covered by Medicare or insurance companies.
Laser-Assisted Cataract Surgery - If you elect the standard IOL, you will also have the option of choosing the technology that is used to performed the procedure. This means you now have the choice between surgery performed by hand or with the assistance of laser technology utilizing the LenSx femtosecond laser. Either type of procedure can be effective when performed by a skilled surgeon, but laser-assited cataract surgery procedures are generally more oredictable and precise. If you opt for laser surgery, a bladeless computer-controlled laser is used to help the surgeon perform your surgery with exacting individualized precision not attainable with traditionalsurgical methods. If you choose this technoloy it is not covered by Medicare or insurance companies.