What do I need to know before cataract surgery?

Published in Cataract Pre-Surgery Questions

What do I need to know before cataract surgery?

Macula - Although not always done, I would consider it a best practice to do an OCT prior to cataract surgery.    The special OCT image is a detailed cross-section of the retina and documents any imperfections or lack-of-imperfections prior to surgery.

Dry Eye - Mild, moderate or severe dry eye can negatively affect the outcome of cataract surgery.  Having a healthy cornea can help your surgeon’s team get better measurements for the implant so make sure that you follow your dry eye protocol to the letter before your measurements (not just prior to the surgery date).  It is NOT worth paying for a better lens implant if you have raging dry eye because the measurement accuracy is poor.

Folks with dry eyes can also have more discomfort post-surgery so ask your team if there is something more that you need to do prior to your surgery. 

Lashes and Lid Care - Poor/inadequate lid hygine prior to cataract surgery increases infection risk.  It is a best practice to use lid scrubs or gel care gel prior to your surgery.  Do not have eyelash extensions use or make-up a few days prior to your surgery date.

 

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Can the implant come loose? Fall out? Can I rub it out?

Published in Cataract Pre-Surgery Questions

Can the implant come loose?  Fall out?  Can I rub it out?

It would be unusual but an implant can come loose.  There are natural elastics (zonules) that hold it in place and if those are damaged by trauma or a degenerative condition… the lens can sink or fall into the back of the eye.   This is repairable but requires further surgery.

An implant can not fall out of the eye… just sink low or fall behind the iris.

This is nothing that you can control.  Touching or rubbing your eyes will not damage the implant.

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Does cataract surgery hurt?

Published in Cataract Pre-Surgery Questions

Does cataract surgery hurt?

It would be extremely unusual for a patient to say in a follow-up visit that cataract removal hurt.  It has happened over my 25 years … but I could count the number of times on one hand.

By far the most common discomfort is a scratchy feeling that often persists for a couple of months post-surgery.

Most folks that reported that they experienced discomfort during the procedure say that it was an anesthetic issue … not enough or perhaps too long between drops and surgery.  This was quickly rectified with increased

anesthetic.

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Can a cataract come back?

Published in Cataract Post-Surgery Questions

Can a cataract come back?

Because the natural lens is removed during cataract surgery, a cataract cannot come back.  However, in approximately 15% of cases, a “secondary cataract” can develop.  This clouding of the bag (capsule) holding the implant gives the same symptoms as the original cataract.  Secondary cataract can develop anytime post-surgery but most commonly within the first few years. 

Secondary cataract (posterior subcapsular opacification) is quick and easy to treat with laser.  The treatment does not require and operating suite so it is done with little wait time.  Secondary cataract does not return once treated.

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Will I have more night glare after cataract surgery?

Published in Cataract Pre-Surgery Questions

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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