Cataract surgery is a highly successful procedure. Over 95% of patients experience improved vision, unless there is a problem with the cornea, retina, optic nerve or other structures.
Cataract surgery is a highly successful procedure. Over 95% of patients experience improved vision, unless there is a problem with the cornea, retina, optic nerve or other structures.
There may be other reasons for visual loss in addition to the cataract, particularly problems involving the retina or optic nerve. If these problems are present, removal of the cataract may improve vision, but perfect sight may not be possible.
If your vision cannot be improved by changing the prescription of eyeglasses and you are limited in doing your daily routine activities such as driving, playing golf, watching television, or reading due to cataract formation, you are a candidate for cataract surgery.
Cataract surgery improves quality of life of people by increasing their independence through improved vision; the ability to drive, work, watch TV, and walk safely.
Sometimes, a cataract should be removed even if it doesn’t cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. Under such circumstances, your cataract surgery is a medical necessity.
There are two primary ways to remove a cataract. Your ophthalmologist can explain the differences and help determine which is best for you:
Phacoemulsification, or phaco or small incision cataract surgery. This method used today is an advanced method of cataract removal. Your ophthalmologist makes a small self-sealing incision on the side of the cornea (the clear, dome-shaped surface that covers the front of the eye). The doctor then inserts a tiny probe into the eye. This device emits ultrasound vibrations (pulsing at 40,000 cycles per second) that soften and break up the cloudy center of the lens so it can be removed by suction. This leaves the outer membrane of the lens intact and transparent and provides support for other vital eye components. A specially formulated fluid replaces the fragments during the suction process. Combined with the foldable lens implant, and no-stitch surgery, phacoemulsification is an advanced method of cataract surgery.Phacoemulsification requires more costly supplies and support equipment than other techniques. The surgeon must also have advanced training and considerable experience. Advocates find these additional requirements to be well worth the cost and effort.Cataract surgery cannot be done with a laser by any surgeon at this time. Cataracts are removed surgically by phacoemulsification method. The YAG laser is used only to treat “after cataracts” but not to remove the cataracts.
No, you will not be able to drive yourself. Someone will need to drive you home after your surgery. Someone will need to drive you back to our office for your first postoperative appointment.
New techniques have significantly reduced healing times. However, each patient’s healing time varies with the type of procedure performed, medical history and physical health. You can expect to go to your work place within a few days.
Some people will see quite well by the next morning. Even with no problems some people will need several weeks of healing for their vision to return to normal.
You should plan to take it easy and not work out or play sports for a week. Aerobic and other exercise programs are not allowed for at least two weeks to decrease the risks of bleeding, swelling and bruising. More strenuous activities, such as weight-lifting and contact sports, are not allowed for at least two weeks. Absolutely no bending, lifting or straining during the postoperative period as these activities can increase swelling and delay healing.
Most patients watch TV and listen to radio 1-2 days after surgery. People generally can read and work at the computer 3-4 days later, though the eyes fatigue faster than usual.
You may take a tub bath and wash your hair in the sink about one week following the procedure. Hot steamy showers should be avoided because they could prolong swelling. Routine showers at one week are fine.
In most cataract surgeries, the removed lens is replaced by an intraocular lens (IOL). An IOL is a clear, artificial lens that requires no care and becomes a permanent part of your eye. With an IOL, you’ll have improved vision because light will be able to pass through it to the retina. Also, you won’t feel or see the new lens.This IOL can be of different material such as plastic, silicon or acrylic. All of these materials are tested for years and do not cause any problem once they are nicely implanted in your eye.
Some people cannot have an IOL. They may have problems during surgery, or maybe they have another eye disease. For these people, a soft contact lens may be suggested. For others, glasses that provide powerful magnification may be better.
An IOL is a permanent replacement for your natural lens. After it has been placed inside your eye during cataract surgery, it requires no further care. You probably won’t be able to feel your new lens; and others will not notice it either. An IOL never needs to be handled, adjusted, or cleaned.
There is a very slightly increased risk of surgical complications, such as displacement of the IOL, but most people feel that the benefits far outweigh the risk. Today, almost all patients having cataract surgery safely choose an IOL as part of the procedure.
A cataract once removed, cannot grow back. However, during cataract surgery the “posterior capsule”, a very thin, clear membrane that wraps around the backside of the cataract is left intact, and eventually this becomes cloudy. This so called “after cataract” can be treated with a YAG laser. This is a painless office procedure, which restores vision in a matter of minutes to patients with “after cataracts”.
A week or two before surgery, your ophthalmologist will measure the curvature of the cornea and the size and shape of the eye. For patients who will receive an IOL, this information helps your doctor to choose the right type of IOL.
Surgery is usually performed on an outpatient basis. The operation usually lasts less than 1 hour and is almost painless. When you arrive for surgery, some eye drops will be instilled to dilate your pupil. Many people choose to stay awake during surgery, while others may need to be put to sleep for a short time. If you are awake, you will have an anesthetic to numb the nerves in and around your eye.
The area around your eye will be thoroughly cleansed, and sterile coverings are placed around your head. Under an operating microscope, a small incision is made in your eye. Microsurgical instruments are used to break apart and suction the cloudy lens from your eye. The back membrane of the lens (called the posterior capsule) is left in place. An intraocular lens implant is placed inside your eye to replace the natural lens that was removed. The incision is then closed. No stitches are used.
After the operation, a patch will be placed over your eye and you will rest for a while. You will be watched by your medical team to see if there are any problems, such as bleeding. Most people who have cataract surgery can go home the same day. Since you will not be able to drive, make sure you make arrangements for a ride.
It’s normal to feel itching and mild discomfort for a while after cataract surgery. Some fluid discharge is also common, and your eye may be sensitive to light and touch. If you have discomfort, your eye doctor may suggest a pain reliever every 4-6 hours. After 1-2 days, even moderate discomfort should disappear. In most cases, healing will take about 6 weeks.
After surgery, your doctor will schedule exams to check on your progress. For a few days after surgery, you may take eye drops or pills to help healing and control the pressure inside your eye. Ask your doctor how to use your medications, when to take them, and what effects they can have.
We see all surgery patients one day after the surgery. Further follow-up will depend upon your individual condition and schedule. Dr. Tandon will be available to see you in the office, if necessary. There is no charge for future visits after surgery.
Yes. Postoperative prescriptions are provided well in advance of surgery day so you arrive home completely prepared. Postoperative prescriptions and over-the-counter medications for cataract patients include the following: an antibiotic drop and an anti-inflammatory drop four times a day. These drops will be tapered off over 3 weeks.
Patients take their pain medication as needed. You will begin the antibiotic and swelling medications when you arrive home from surgery or next day after surgery.
Cataract surgery and lens implantation are intended to restore your vision to normal, minimizing your dependence on glasses / contacts. Although many patients are able to function without glasses, most patients will find that they need glasses for near vision (reading and close-up work), distant vision, or both after cataract surgery.
Yes, the eye is healing and may feel irritated at times. This experience usually clears in 1-3 weeks. Lubrication with artificial tears may help and excessive dryness may be present at first.
For the first few hours there may be some discomfort, but usually not severe. If the pain persists, call your doctor.
You can quickly return to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.
If you just received an IOL, you may notice that colors are very bright or have a blue tinge. Also, if you’ve been in bright sunlight, everything may be reddish for a few hours. If you see these color tinges, it is because your lens is clear and no longer cloudy. Within a few months after receiving an IOL, these colors should go away. And when you have healed, you will probably need new glasses.
Your sight will usually improve within a few days, although complete healing may take several months. It is a good idea to have some help at home if you can, especially if you find it difficult to put your eye drops in. You can do light housework, cooking, walk, and climb stairs.
With the eye guard taped in place, you can sleep on either side. If the guard is off try to sleep on the opposite side.
Wear the sunglasses when outdoors for about a week. If you prefer you may wear your own sunglasses. There is no need to wear them indoors or outdoors in dim or overcast light.
Small or conspicuous blood spots over the white of the eye are common. They are harmless and usually clear in a matter of days or weeks.
Sometimes the thin natural bag (capsule) that supports the intraocular lens becomes cloudy and may blur your vision. This is called an after-cataract. An after-cataract can develop months or years later. Unlike a cataract, an after-cataract is treated with a laser. In a technique called YAG laser capsulotomy, your doctor uses a laser beam to make a tiny hole in the lens capsule to let light pass through. This is a painless outpatient procedure.
Your old glasses may be adequate at first. You won’t harm the eye by wearing old glasses. After a couple of weeks the eye may be ready for testing and preliminary lens replacement. However, if you wait until about 4-6 weeks, refraction will be more stable.
As soon as you see well enough to be confident, are alert from medication, and you are comfortable in the lighting of the day or night.
Use the eye drops for at least a 3-4 weeks in tapering dose as instructed by your eye doctor.
Glaucoma is a disease that results in the damage of optic nerve due to high eye pressure. A person may lose peripheral vision due to nerve damage. This loss of vision is permanent and cannot be regained. In contrast, cataract can cause loss of vision which can be regained by successful cataract surgery. Sometimes, cataract and glaucoma can occur together in the same eye.
Yes. Continue with your drops on the other eye as usual.
If the second eye is appropriate for surgery, as little as two weeks may elapse between surgeries, that is if it’s convenient for you and agreed upon by your surgeon.
In adults, cataract usually causes blurry vision which is reversible if cataract is surgically removed. Rarely, hypermature cataract can induce glaucoma or inflammation in your eye and urgent cataract removal is recommended. If an infant or newborn child has cataract, it can cause permanent blindness. Cataract surgery is urgent in this situation.
Yes. If a child is more than 3 years old, lens implant can be considered. The lens power may not be calculated very precisely in children because of the growing age.
Children with this condition may have to be treated with steroids. Eye inflammations associated with this condition are usually treated with long term steroid eye drops. Cataract and glaucoma at the young age may be the result of this treatment. A routine and thorough eye examination is recommended to diagnose and treat glaucoma and cataract in these children.
With prompt medical attention, most of the complications usually can be treated successfully. Possible complications that could occur during surgery include the following:
Typically, your vision will decline and the eye may become achy. In a matter of hours the vision may be totally foggy. Call your doctor or seek emergency help. The greatest risk is during the first week.
Schedule a pre-op appointment with your surgeon at NeoVision Eye Center. In keeping with our efforts to maintain the highest standards of patient safety and in an ongoing effort to avoid possible complications, we ask that each of our cataract patients undergo an extensive and comprehensive eye exam by an ophthalmologist prior to surgery. During your pre-op visit, your health history will be reviewed, all your questions will be answered, you will be instructed on how to prepare for surgery, you will be given the prescriptions for use after surgery and we will tell you what to expect. If you are on blood thinners, you will be asked to stop them approximately one week prior to surgery. You will be asked to sign an informed consent.
Informed consent means you have an excellent understanding about the benefits of surgery as well as any risks, and all the preoperative and postoperative information. You are making an “informed” decision as to whether surgery is right for you.
Dr. Tandon will meet with you, examine you, and discuss all the possible complications, answer all of your questions, and perform the surgery. Dr. Tandon, MD, PhD is a trained eye physician and surgeon from Stanford University. She is a Certified by American Board of Ophthalmology.
At NeoVision Eye Center, we believe the fairest approach is to offer cataract surgery for one Flat Fee. That is why we offer one global comprehensive fee, which includes all pre-operative, surgical, and post-operative care. A price estimate will be given at your consultation for cataract surgery. Fees reflect the specific problem that you have and the extent of surgery to correct it
Most of these operations are covered by insurance. If cataract is interfering in your field of vision, the procedure may be covered as a “medically necessary” surgery and some insurance plans will pay for all or part of the surgery. You should check with your insurance carrier about the coverage.
Schedule an appointment at NeoVision Eye Center by calling today at:1-510-431-5511.
