Cataract Surgery: What To Expect

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Cataract surgery is one of the most common surgical procedures. We all get cataracts if we live long enough. A cataract is a clouding of the natural lens inside the eye that causes blurry vision and glare. When a cataract is moderately advanced, there are no other treatments such as drops or medications that can be used to improve your vision. When cataracts interfere with your ability to see and do things that are important to you, you may consider cataract surgery to improve your vision. Cataract surgery involves removing the cloudy cataract lens and replacing it with an artificial implant lens.

Preoperative Evaluation

If you have blurry vision or glare (trouble seeing in bright sunlight or when driving with oncoming headlights), you should see your ophthalmologist or optometrist. They will be able to tell you if your vision can be improved with glasses, or if something is wrong. There are a number of medical conditions that can lead to blurry vision such as cataract, macular degeneration, diabetes and others. If cataracts are the problem and your ophthalmologist is one who performs cataract surgery, they will discuss the options with you. If they do not perform cataract surgery, they may refer you to an ophthalmologist who does.

During the preoperative visit with your ophthalmologist, you will have a relatively lengthy and thorough evaluation. Testing at Rutzen Eye Specialists includes measurement of focusing (refraction), corneal mapping (to measure the shape of the front of the eye), lens measurements (to determine the correct power of the artificial implant lens that is inserted at the time of surgery) and examination with your pupils dilated.

After measurements are performed, your ophthalmologist can discuss the various choices of artificial implant lenses that are available. There are now more choices than ever before. Some implants are generally used to focus at a distance and require the use of reading glasses to see things up close. Other implants known as multifocal lenses can help you focus both at a distance and up close for reading. Multifocal lenses can reduce your need for reading glasses after surgery. Other special implant lenses can correct astigmatism, a particular type of distortion in focusing.

Another aspect of surgery that you should discuss is the choice between standard cataract surgery and laser-assisted cataract surgery. Not all cataract surgeons offer laser-assisted cataract surgery. With laser-assisted cataract surgery, your surgeon uses a laser to perform several of the key steps in cataract surgery: 1) creating the incisions, 2) treating astigmatism, 3) opening the capsule of the cataract and 4) softening and breaking up the cataract. After the laser has been used for these steps, manual surgery to vacuum out the cataract is performed, and the artificial implant is inserted. Laser-assisted cataract surgery has the potential to make your vision clearer through treatment of astigmatism and by reducing the amount of energy needed to vacuum out the cataract, thereby reducing the trauma of surgery. Laser-assisted cataract surgery and some implant lenses are not covered by insurance and have an out-of-pocket expense.

Day Of Surgery

Cataract surgery is usually performed in a surgery center or in a hospital. I perform cataract surgery in an ophthalmic surgery center that is designed specifically for eye surgery. Cataract surgery is outpatient surgery, so you come and go the same day.

After you register with the receptionist, you will be given some drops to dilate the pupil in the eye that is scheduled for surgery. Nurses and anesthesiology staff will speak with you to confirm the surgery plan and to review your medical history. Most patients receive an intravenous catheter so that they can receive sedation to feel more relaxed during surgery.

If you elected to have laser-assisted cataract surgery, you will be brought into the laser room reclining on a stretcher. You will lie down under the laser as the ophthalmologist and staff enter your particular parameters into the laser. Numbing drops will be applied so that you don't feel any pain. An eyelid holder is used to help you keep your eye open during the treatment. The planning step may take a few minutes, but the actual laser treatment is 30-60 seconds.

After the laser treatment, you are brought on the stretcher into the operating room. The staff uses an iodine solution to clean around your eye, and a translucent plastic drape is placed over your eye to keep it sterile. When the surgeon starts surgery, you won't feel any discomfort, but you will see a "light show" of moving lights and colors as the cataract is vacuumed out and the implant lens is inserted. The actual surgery is brief, usually taking 10 to 20 minutes.

Following surgery, you are brought to the post-op area for something to eat and drink and to receive post-op instructions from the nurses. Your eye will remain open without the need for a patch. Most of my patients see better on the first day than they did prior to surgery.

If a person has a cataract in both eyes, we don’t do cataract surgery on both eyes at the same time. I recommend waiting one to two weeks after the first eye so that we are sure all is going well with the first surgery.

Postoperative Care

I usually see patients in the office for a checkup one day, one week and one month following surgery. Patients use eye drops to prevent infection and to decrease inflammation for three to four weeks after surgery. Many patients see well without glasses, but some patients choose to get glasses, such as progressive lenses or reading glasses. You can get new glasses, if needed, about three weeks after surgery.

Deciding On Cataract Surgery

If you are considering surgery, you should discuss your particular situation with your eye doctor. The overall success rate of cataract surgery is excellent, but every person is different, and there are some conditions that increase the risk of surgery. You should feel comfortable discussing the risks and benefits of cataract surgery with your doctor.

It is also important for you to consider how you use your eyes, and if you have any particular vision needs for your occupation, hobbies or sports. I like to get a thorough understanding of how you use your eyes in order to be able to discuss the advantages and disadvantages of various types of implant lenses.

Cataract surgery can improve your vision and allow you to see the things you have been missing. You want your surgery to be performed as skillfully and safely as possible.

If you are considering cataract surgery, call Rutzen Eye Specialists & Laser Center at 410-975-0090 to make an appointment with Dr. Allan Rutzen. His office is located in Severna Park at 489 Ritchie Highway, Suite 200. Visit www.rutzeneye.com for more information about cataract surgery and the new LenSx bladeless cataract surgery.

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