Cataract Surgery Information:

What is a cataract?   Why do cataracts develop?   What are the symptoms of cataracts?   Will new glasses help people with cataracts see better?   Can cataracts be reversed or prevented?   Do cataracts occur in both eyes at the same time?   When should I have my cataract removed and why?   Is surgery performed in a hospital or as a outpatient?

How long does the surgery take?   Is cataract surgery performed under a general anesthesia?   Is cataract surgery painful?   How is the cataract removed?   After the surgery will my cataract come back?   Will I need reading glasses after surgery?   What restrictions will I have after cataract surgery?   What are the risks of cataract surgery?

About Cataracts

What are the symptoms of cataracts?
Early on, cataract symptoms can be very mild. Most people notice that a distracting glare from oncoming headlights when they drive at night. Also, it may require more and more light to comfortably read, even while wearing glasses. Some people notice that television captions become increasingly difficult to read.

Eye with Normal Lens		Eye with cataract in lens
Normal Eye A healthy, clear lens allows a sharp image to fall on every part of the retina allowing a crisp, clear image to be seen.		Cataract Eye A cloudy lens scatters light, causing a hazy image to be seen.

Will new glasses help people with cataracts see better?
Sometimes they do. During a complete eye examination, we evaluate vision and the total health of the eye, also screening for other disorders like glaucoma, macular degeneration, and diabetes. This allows us to determine whether a change in glasses would provide a significant improvement in vision. When cataracts become severe, even new glasses will not help because the eye is seeing through a cloudy internal lens that can not be corrected with glasses.

Can cataracts be reversed or prevented?
Wearing ultraviolet (UV) protecting sunglasses may help reduce the progression of cataract. It is worthwhile for most people to investing in a good quality pair of sunglasses, which need not be very expensive. Also, a balanced diet containing a reasonable amount of antioxidant vitamins may help prevent cataracts.

Do cataracts happen to both eyes at the same time?
Generally, cataracts progress at about the same rate in both eyes. Many people are more bothered by cataract symptoms in one eye first, however. During an examination, we can determine whether any other conditions such as macular degeneration are also contributing to difficulty with vision.

When should I have my cataract removed and why?
We no longer recommend surgery when a cataract is "ripe". Rather, the decision for surgery is based on when visual difficulties begin to interfere with normal activities of daily living, like driving, reading, work, or hobbies.

Is cataract surgery performed in a hospital or as a outpatient?
Cataract surgery is performed as a outpatient in our own Ambulatory Surgery Center located in San Clement, adjacent to our office. The nursing staff at the Center specializes in only eye surgery. They are, therefore, highly skilled in helping patients comfortably go through the steps of surgery.

How long does the cataract surgery take?
Surgery itself takes about ten minutes in the operating room. Most people are in the Center for about 90 minutes, including pre- and postoperative time.

Is cataract surgery performed under a general anesthesia?
Cataract surgery is performed with local anesthesia only. We provide intravenous medications to help patients fully relax. We also administer local medicines around the eye so that patients don't feel anything and don't see anything during surgery.

Is it cataract surgery painful?
Most people say that there is no pain during or after cataract surgery. They may experience a scratchy sensation (like an eyelash in the eye) and mild soreness for about 24 hours after surgery. If necessary, they take aspirin, Advil (ibuprofen), or Tylenol (acetaminophen). Stronger pain medicine is also available if necessary.

How is the cataract removed?
The cataract is removed in a ten minute procedure where a small opening (less than 1/8 inch) is made in the front of the eye (the cornea) to allow the surgeon to dissolve the lens of the eye and remove it in tiny pieces. An artificial lens implant made of silicone or plastic is folded into a small package, then inserted into the eye and unfolded in the proper position. In this position, the new lens will remain permanently. It will never need maintenance or replacement. The new lens can be selected to correct nearsightedness or farsightedness.

After the surgery will my cataract come back?
After cataract surgery it is impossible for a cataract to come back because the lens of the eye, where the cataract grows, has been removed. The new lens implant will last a lifetime and never need maintenance or replacement. It is possible, however, for a cloudy film to grow on the lens capsule membrane that is located behind the lens implant. This occurs in about 40% of cataract surgery patients but, usually many months or years after surgery. Treatment of this film, sometimes called a "secondary cataract", is done with a laser in a simple outpatient procedure that involves no postoperative restrictions or downtime for most people.

Will I need reading glasses after cataract surgery?
With lens implant technology, our surgeons can choose to correct vision to achieve good uncorrected distance vision in both eyes. This allows most people to pass a Department of Motor Vehicles (DMV) test without glasses. In such a case, it would be necessary to wear reading glasses for fine print, though some large print reading may be possible without glasses.
Another option after surgery is monovision. This option allows many people both to read and drive without corrective lenses. This option is usually most successful in people who have previously worn monovision contact lenses or who have had monovision LASIK.

Crystalens technology is another method of achieving good distance and reading vision after cataract surgery. For more information about Crystalens surgery, click here.

What restrictions will I have after cataract surgery?
For the first four hours after surgery, an eye patch is placed on the healing eye and the effects of anesthesia will be wearing off. During this time we recommend restful activity. Eating, watching television, reading, and walking around the house are allowed. After the eye patch is removed, patients can begin administering their postoperative eye drops.

For the first few days after surgery, heavy lifting (more than 20 pounds) is not allowed, and we recommend avoiding eye makeup for one week.

There are other restrictions as well after surgery. These are fully discussed with our doctors and counselors before surgery. For more information about restrictions after surgery, contact us.

What are the risks of cataract surgery?
There are risks with every kind of surgery, and cataract surgery is no exception. The risk of severe complications, such as infection, severe bleeding during surgery, or retinal detachment are about 1 in 1000. Other, less severe complications of surgery may occur more frequently, as often as 1 in 100 times. These less severe complications can include the need for additional surgery or prolonged recovery time with delayed visual improvement.

This is not a complete list of risks that occur with surgery, and individual patients may have other risks based on their co-existing medical or eye conditions. Our doctors have extensive experience performing cataract surgery in unusual circumstances and can fully discuss these risks during an office consultation. Contact us to schedule your consultation for cataract surgery.