What is the wait time for cataract surgery (Ontario)?

I can only speak to this for those of us in Ontario, Canada. 

Wait times for cataract surgery in Ontario vary dramatically depending upon surgeons, budgets and operating room time available for surgeons.

As of now – March 2020 – in London, Ontario… the wait times are approximately eight months from time of referral to time of surgery. 

In Ontario, you have the ability to go to a private center for cataract surgery.  If you are interested in this, you should discuss this with your Optometrist prior to your referral.   A private center may influence your wait time but not significantly.  Privately paying for a medical service can not buy your way to the front of the line but because less folks pay, the queue is shorter after you are assessed in your initial surgery consult.

How much does cataract surgery cost?

I can only speak to this for those of us in Ontario, Canada. 

If you have a visually significant cataract and desired, you could have cataract surgery done at no charge in Ontario.  However, most of my patients spend approximately $300-$400 per eye to have premium implants and the associated measurements.

If you elected to have an enhanced procedure or had a significant amount of astigmatism that you wanted to concurrently correct with surgery… these costs range from $1000 - $2500 extra per eye.

Speak to your surgeon about the $ details

Ultrasound vs. laser … Is cataract surgery not always done with laser?

There is a common misconception that all cataract surgery is done with laser.  Perhaps because the procedure is so quick and efficient or that there is so much advertising for LASIK refractive surgery… but patients often confuse the two surgeries and how the procedure is done.

The two main clarifications that I make with patients are:

1] Cataract Surgery is not LASIK.   LASIK is a laser-based procedure to reshape the cornea (the outer surface) of the eye.  Cataract surgery removes the cloudy lens from inside the eye and replaces it with an implant.   In some circumstances these two procedures can be combined (not concurrently) but they are different procedures requiring different technologies and surgeon skill sets.

2] Cataract removal surgery typically uses ultrasound energy (not laser) to break up the natural lens to remove it.  However, laser energy can also be used for this purpose.  This is an increasingly popular option … but it is not widely done in this region - Ontario. 

What are the pre-surgery eye measurements required for implants?

There are several eye measurements that a surgeon will take into consideration for your surgery.

1] The refraction (your glasses prescription)
2] The curve of the cornea
3] Measurements of the length of the eye (ultrasound)

These are all used to determine the best implant.   In this region, some of these measures are come with extra charges.  I always recommended these measurements be taken (even if a charge) because it does improve the accuracy of the final post-surgery glasses prescription (or lack thereof!).

Are there needles used in cataract surgery?

This is a common concern for folks as we discuss how the procedure is done.   It is extremely unlikely that needle would be required for the procedure.   Eye drops are used to numb the eye and dilated the pupil prior to surgery.

In rare circumstance, the only needle that is used is to place anesthetic behind the eyeball so that it temporary paralysis the eye muscles.

I have heard of doing one eye for distance and one eye for near?

Monovision is a method to fit contact lenses or determine the power of implants which intentionally creates clarity in the distance in one eye and clarity up close with the other eye.   It works well with early focusing difficulties but tends to fail as one requires increasingly different close/far powers with age.  Because implants do not have any dynamic focusing ability, the near/far powers are quite different.

In my experience this arrangement is not suitable for implants UNLESS the patient currently, successfully wears monovision-fit contact lenses.

It would be possible to trial contact lenses prior to surgery to simulate monovision but sometimes the cataract cloudiness is so significant that a proper trial is a challenge.

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.

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.