Frequently Asked Questions About Cataract & Lens Replacement Surgery
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What is a Cataract?Inside your eye is a natural lens that helps focus light from outside your eye. The lens creates images in the back of your eye (called the retina) like a camera focuses images on film. As people age, the lens naturally becomes less clear, even cloudy. This cloudiness in the lens is called a cataract. Typical signs of cataracts are blurred vision and sensitivity to light especially while driving at night or at dusk. Colors may seem less vivid and it may be difficult to thread a needle, shave or put on makeup.
What causes Cataracts?Although the majority of cataracts develop on their own, as part of the natural aging process, there are certain risk factors that can contribute to cataracts developing earlier, or at an accelerated rate. Risk factors include: Trauma to the eye, including injury, burns or surgery. Toxins, including regular use of tobacco, alcohol or corticosteroids. Exposure to radiation, X-rays or ultraviolet (UV) light. Certain diseases, including diabetes, hypothyroidism and glaucoma. Heredity can also play a factor in determining when cataracts form.
Does Cataract and lens replacement surgery hurt?No! Thanks to numbing drops and medications to help you relax, this procedure involves minimal discomfort. It is normal to experience some scratchiness, foreign body sensation, or a mild headache during the first 24 hours after surgery, but severe pain is rare and should be reported to Dr. Spencer right away.
What are the risks of cataract surgery? Could I go blind?Just like any surgical procedure, cataract surgery does have risks that can even include blindness. Fortunately, Dr. Spencer takes every precaution to minimize those risks, and has an extraordinary success rate with this procedure.
Will I be asleep for the surgery?Since the procedure does not take very long, it is unnecessary to put you to sleep with general anesthesia. Fortunately this makes your surgery even safer. Instead, we will use topical/local anesthesia to numb the eye and you will remain awake during surgery. You will also be given an I.V. line placed into your arm for additional medicine to help you relax.
Will Dr. Spencer do surgery on both at the same time?No, only one eye will be operated on at a time. Typically, we will perform surgery on the following eye 3 to 4 weeks after the first eye. All patients are different and heal at different rates, so speak with us further to learn what is appropriate for you.
How long will I be in surgery?The surgery itself is very quick and usually lasts less than 15 minutes. However, due to pre-operative preparation and brief post-op recovery, your entire stay in the surgical center will be 2 to 2 1/2 hours.
Can I drive myself the day of surgery?No, even if you elect not to have relaxing medication administered before surgery, your vision will be blurry in the operative eye (due to dilation and anesthesia) and not suitable for driving. You must arrange for transportation to and from the surgical center.
Will I have stitches or have to wear a patch?Dr. Spencer uses the most modern technique for cataract and lens replacement surgery that involves creating a tiny incision with either a laser or a blade that self-seals and does not require stitches. You will have the ability to see and blink. We will provide you with an eye shield to wear while you are sleeping during the first week. This is used to protect your eye so that you don't rub it or put pressure on it while sleeping.
How long before I can see after surgery?Every patient and eye is different, but many patients see well enough to drive the day after their surgery.
When can I resume normal activities or sports?Most patients can return to normal basic activities like reading and watching TV by the next day, and return to work within one to seven days. However, results vary for different patients, so you should ask Dr. Spencer if you have questions about specific activities. We usually recommend that you avoid rubbing your eye, engaging in activities like sports where an object could hit the eye, and getting dust, dirt or sand in the eye. We also advise you to avoid swimming for two weeks after surgery. You may exercise if you avoid high impact activity during the first week. Most patient resume golf, tennis and other active sports or hobbies within one week.
After surgery, will I be able to drive at night?You should find that your ability to drive at night is improved once your cataract is removed. Once a lens has been implanted, you might notice rings, halos, or starbursts around point sources of light such as headlights or streetlights. This effect may be more noticeable with certain types of Multifocal Lens Implants. Fortunately, these visual effects are typically mild, rarely bothersome, and tend to diminish with time.
Will I need glasses after cataract and lens replacement surgery?This will depend on what type of Intraocular Lens you choose to have implanted as well as unique aspects to your eyes such as the presence and amount of astigmatism. Many people mistakenly believe that simply having cataract surgery will enable them to see perfectly without glasses. While having cataract surgery can improve the vision, the conventional lens implant is a single, fixed focus lens. It cannot give distance vision one moment and near vision the next (like the eye's natural lens does in a young person). To learn more about which lens implants can decrease your dependence on glasses, ask Dr. Spencer or your surgical coordinator.
What is the best type of intraocular lens implant?There is no one best intraocular lens implant. Selection of a lens implant is a very personal choice based on your visual needs, eye conditions, and postoperative expectations. This decision will be made by you with close discussion between our surgical counselor and Dr. Spencer.
I am choosing a multifocal premium lens. Can I only get it in one eye or am I required to have it placed in both eyes?When choosing an intraocular lens it is important to keep in mind that your vision works best when both eyes are focusing together. In most cases the answer is YES, however Dr. Spencer will review your personal needs.
If I elect to have surgery with a Multifocal or Toric Atigmatism Correcting Lens implant, what happens if my prescription were to ever change but I want to continue with minimal need for glasses?If you should experience changes whereby you develop nearsightedness, farsightedness, or astigmatism, then you may be a candidate for a vision correction procedure or 'enhancement' such as laser PhotoRefractive Keratectomy.
If I need glasses after cataract surgery, how soon can I get a prescription?The eye typically takes 3 to 4 weeks to stabilize after cataract surgery. It is recommended that you wait until then to have a prescription made so as to allow for the most stable result. While your prescription will be more stable, the average lifespan of a pair of eyeglasses is approximately two years due to scratching, breakdown of lens coatings, and other wear and tear. For this reason, if you have opted for a lens implant still requiring you to wear eyeglasses, then you will still find a need to change your eyeglasses approximately every two years.
Will my medical insurance cover a Multifocal Lens or Toric Astigmatism Correcting Lens?No, surprisingly, the additional charge for implanting these special lenses is not covered and must be paid out-of-pocket by the patient.Because these lenses have nothing to do with improving the health of your eye, insurance companies and Medicare do not view them as 'medically necessary.
Can my cataract come back?No, once a cataract has been removed, a new cataract cannot develop. Lens implants do not cloud over like human lenses do. However, over time many patients may notice that their vision has once again become cloudy. This fairly common condition which may occur with any type of lens implant is known as posterior capsular opacification or 'PCO'. Some doctors refer to it as a 'secondary cataract' because the visual symptoms are similar to those of a cataract. If the PCO becomes bothersome, Dr. Spencer can clear it away with a relatively simple laser procedure, known as a Yag Laser Capsulotomy.
What might I notice immediately after surgery while my eye is healing?Your eye may be sensitive to light and wind and may have some watering and tearing for a couple of weeks following surgery. It is also normal to experience a slight aching or tenderness to the eye as well as irritation, scratchiness, and dryness. You will likely notice fluctuations in your vision that might include the appearance of a shimmering or flickering to your vision and will gradually improve over the first couple weeks following surgery. The changes generally should not be severe enough to interfere with your day to day activities.
Are there any common side effects that may last more than a couple weeks?One of the most common side effects of cataract surgery is the temporary development or worsening of dry eye syndrome. These symptoms most often improve or subside within the first 3 months after surgery however in some cases they may last up to one year or beyond. Fortunately, we have a number of treatments to improve or alleviate your dry eye symptoms. Ask Dr. Spencer about your options.
Are there any side effects to Multifocal lenses?Most patients will notice some amount of a ring or halo effect around point sources of light at night, especially in the first few days after surgery while the pupil is dilated. These are different from and less problematic than halos caused by cataracts. Fortunately, this effect is usually mild, generally does not interfere with your visual function, and tends to decrease throughout the course of the first year. During the first couple of weeks after surgery, some patients describe differences in the crispness of their near or intermediate vision when compared with their distance vision. With time, healing and adaptation to the lens implant optics, the crispness of each of these zones of vision tends to become more equal.
Will cataract surgery get rid of my floaters?No. Though it is possible for patients to notice some changes to their floaters when they have gone through cataract surgery, you should not expect for cataract surgery to get rid of your floaters.
What are negative dysphotopsias?Negative dysphotopsias are the appearance of a dark line or parenthesis out of the corner of your peripheral vision that may be described as a dark shadow. This visual effect may occur in patients who have had otherwise perfect surgery with any type of intraocular lens implant. Though it is not well understood why this phenomenon occurs, it is believed to be related to changes in the optical system of the eye with the introduction of the lens implant. This temporarily creates an arc-shaped shadow over the peripheral retina when light enters and reflects within the lens implant. Fortunately, this effect generally goes away over 6 to 12 months after cataract surgery in most patients.
Can the lens be replaced if it doesn't work? Does it ever need to be replaced?Although this would be considerably unlikely for it not to work, the lens implant or IOL can be replaced with a different one, if needed. Overall, lens implants are intended to be permanent and never need to be replaced under normal circumstances. The first lens implants were used starting after World War II, so there is considerable data supporting the long-term safety of lens implants.