Cataract Pre-Surgery Questions

Cataract Pre-Surgery Questions (31)

Cataract Pre-Surgery Questions: 56 Things that you wish you knew before your cataract surgery

Are both eyes done at the same time?

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Are both eyes done at the same time?

Bilateral surgery varies by regional / surgeon.  In my area – Ontario Canada – it would be highly unusual to have bilateral cataract removal surgery.

This is done primarily to minimize infection risk.  Also, you will be patched for a short time after surgery as well.  Bilateral surgery would mean no sight or independence during this time.

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Will I have more night glare after cataract surgery?

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Will I have more night glare after cataract surgery?

Maybe – The type of implant that you select / receive will influence night vision.  Some lenses are optically designed to help correct the aberrations associated with night glare.  Common post cataract surgery night vision issues are: glare, arcs, haloes, flashes, blur.

In some cases folks’ pupils are larger and/or less responsive post-surgery and this change effects the optics of the eye.

If you are in need of cataract surgery ... then you probably have a glare-causing cataract.   Your post surgical level of glare should be less than your current!

Important – A great pair of new lenses can do wonders to reduce glare.  It is not always the implant’s optics to blame!  You may just have a bit of residual prescription to be corrected.

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Will I be more light sensitive after cataract surgery?

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Will I be more light sensitive after cataract surgery?

Immediately after surgery you will more light sensitive.  You will have inflammation in the eye that will cause increased light sensitivity.  Wear sunglasses!  You will also be light sensitive because the new, clear implant allows much more light into the eye vs. the cloudy natural lens that was removed.

Most folks say that their light sensitivity decreased significantly over the first couple of months post-surgery.

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Can cataract surgery make my macular degeneration (AMD) worse?

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Can cataract surgery make my macular degeneration (AMD) worse?

The jury is still out here.  Speak to your surgeon but most surgeons will wait until the cataract absolutely needs to be done if there are macular concerns.

There is a school-of-thought that laser enhanced cataract surgery (femtosecond laser) is safer for AMD patients because it introduces less energy into the eye with therefore less chance of retinal inflammation.

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Should I get a bifocal / multifocal implant?

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Should I get a bifocal / multifocal implant?

Some cataract surgeons will offer bifocal / multifocal implants.  These lenses ideally eliminate the need for distance and near glasses post-surgery.   Your case is unique and needs to be discussed with your eye care team but these are the general points that I speak to patients about regarding this premium option:

1] needs to be bilateral to work well [a] do both eyes on a short timeline and [b] consider if you lost vision from one eye in the future
2] good for general near vision but not detail.   Readers may still be required
3] may add to night glare
4] tremendous freedom
5] In my opinion, people who have previously successfully worn multifocal contact lenses make the best candidates
6] significantly more expensive

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How fast does cataract surgery need to be done?

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How fast does cataract surgery need to be done?

An uncomplicated cataract does not need to be urgently treated however cataracts are progressive and vision will inevitably get worse.  There is a point where the risk to remove an advanced cataract increases as higher amounts of ultrasound energy are required.

This is a conversation to have with your eye care professional.

Be careful of driver’s license requirements.  In some regions there are long waits for cataract surgery and you would not want to fall under a driving requirement while waiting.

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I am confused about the enhanced implant and procedure options available for cataract surgery

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I am confused about the enhanced implant and procedure options available for cataract surgery

Basic Cataract Surgery (lowest cost to patient or payor)  This procedure is usually hospital-based.  It is safe and effective and provides the medically necessary cataract surgery procedure with standard lens implant. 

Enhanced Cataract Surgery This typically hospital-based surgery is the same procedure as basic (above) however the lens implanted & the calculations around lens selection are improved.  The enhanced procedure often leads to a better refractive result post-surgery with less night glare. (no astigmatism correction)

Enhanced Cataract/Refractive Surgery  This procedure is done at a private facility that also offers LASIK.  There is great emphasis on achieving the best distance refractive result (i.e. no glasses for far vision).   Superior pre-surgery lens measurements and calculations are coupled with additional in-surgery procedures and post-surgery laser (LASIK if required and suitable) to deliver visual acuity excellence.  Low pre-existing astigmatism is corrected by this surgery. 

Enhanced Cataract/Refractive Surgery for Astigmatism  Hospital or private facility based procedure for higher degrees of pre-existing astigmatism.   There is great emphasis on achieving the best distance refractive result (i.e. no glasses for far vision).   Superior pre-surgery lens measurements and calculations predict the best special (toric) implant lens.

Enhanced+ Cataract/Refractive Surgery with a multifocal lens  Same as Enhanced Surgery above but the multifocal implant corrects both distance AND near vision and eliminates the need for reading glasses for most normal daily functions.

Enhanced Cataract/Refractive Surgery Procedure utilizing laser (for any above enhanced surgeries)  Instead of a blade and ultrasound...  laser technology is used for both making incisions and to remove your clouded natural lens.  Utilizing laser technology is thought to causes less trauma/inflammation to the delicate tissues of the eye and may be safer for some patients, shortens healing times and delivers a more precise end result.  Discuss details and current results with your surgeon.    Not generally available in hospital environments.

 

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I am scared of seeing a knife! Can I see what is happening?

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I am scared of seeing a knife!  Can I see what is happening?

There is so much light flooding you and the operating suite plus... they are working so close to your face… you will not see anything.

You will hear the team … but not see the procedure happening.

Lots of folks are very queasy when it comes to their eyes.  When they come back after surgery... it is always "Well that was not so bad!"

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How long does cataract surgery take? They put you out right?

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How long does cataract surgery take?   Is it under general anesthetic?

Typical, uncomplicated cataract surgery will take about 10 minutes to perform.  However, with preparation and waiting, most patients are at the surgery centre for several hours.  

General anesthetic will not be used unless there are special circumstances.  The anesthesiologist may give you some medication to relax.

Cataract removal is day surgery and you will not be admitted to a hospital unless something very unexpected was to happen. 

Lots of folks are very queazy when it comes to their eyes.  When they come back after surgery... it is always "Well that was not so bad!"

 

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