Cataract Surgery

What is a cataract?

A cataract is a clouding of the natural lens inside your eye located behind your iris. This lens is responsible for focusing light and producing a clear image on the retina at the back of your eye. When this lens gets clouded the light is diffused and scattered which results in the blurring and defocusing of your vision. In some cases, cataracts can develop very rapidly. While generally this happens in elderly people, it has been known to happen in younger people and even infants. Currently, there is no medical treatment (drops or pills) that will prevent or reverse the formation of cataract. Surgery is the only option.

What are the causes of Cataracts?

The American Optometric Association (AOA) lists several reasons for the development of cataracts. While most cataracts are the result of age-related changes to the natural lens, there can be other factors. Health conditions such as diabetes, vitamin deficiencies, and glaucoma can result in the development of cataracts. Ultraviolet radiation, smoking, alcohol and prolonged use of steroids are other factors.  Even eye trauma can result in the formation of cataracts. 

What are the symptoms of cataracts?

Visual symptoms of cataracts can vary from person to person. Most people experience a decrease in vision, glare or halos around light sources making night driving difficult, a “yellow” hue to objects, difficulty reading and performing normal daily activities. When these symptoms occur and your doctor can no longer improve your vision, it may be time for cataract surgery. 

How is cataract treated?

A cataract is treated with an outpatient surgical procedure

What is cataract surgery?

Cataract Surgery is the removal of your natural clouded lens and replacing it with a new clear artificial lens called an ‘Intraocular Lens’ (IOL). The surgeons traditionally perform this procedure by making a tiny incision in the eye with an instrument about the size of a pen tip. Thanks to huge medical advances, several of the most critical steps of cataract surgery can now be performed with a computer-guided refractive cataract laser called ‘LenSx’ laser. The LenSx laser cataract procedure is bladeless and has significantly increased surgical precision.

For years cataract surgery has been performed using a scalpel to enter the eye and a process called phacoemulsification to break up the cataract. Now, a laser is used to make a much smaller incisions into the eye as well as break up the cataract for removal. This means less time is needed for the surgeon and, less discomfort and faster recovery time for the patient. Prior to the implementation of the laser, this opening was made by hand. The opening was not always precise and could vary in size and location (not always centered). If you have elected to proceed with cataract surgery, below please find some more information that will help you with your decision.

What are the advantages of LenSx laser (bladeless) vs. traditional cataract surgery?

Precision and Accuracy

The LenSx laser uses a range of highly advanced technologies to capture precise images and measurements and uses the data to perform the critical procedures in cataract surgery with precision and accuracy. This precision has made the lens placement and post-operative outcomes more predictable, greatly enhancing the benefits of lens implants.

Safety and Comfort

Most people do not feel any pain at all during the bladeless cataract procedure. The procedure takes usually ten to thirty minutes.

Custom Tailored for your Eyes

Every human eye is a little different in terms of size, depth, and curvature of the cornea and other key features. Therefore, the LenSx laser incorporates a variety of highly advanced technologies to obtain precise measurements and images to perform the most critical and delicate procedures in cataract surgery.  For example, The laser is also capable of making additional incisions that relax the cornea to adjust for astigmatism.

Which Intraocular Lens (IOL) is right for you?

Prior to surgery a series of diagnostic tests will be performed on your eye so that your eyecare provider can determine the power and type of implant (IOL - Intraocular lens) needed for you. Every eye is different and so there is no “one size fits all”. This will be done several days or even weeks in advance of your surgery. Also, during your surgical procedure the refraction of your eye is measured using the Optiwave refractive analysis (ORA) system to confirm your IOL prescription. 

Lens Implant Options

There are different intra-ocular lens implants (IOL’s) available to help you reach your post- operative visual goal. These lens options are considered either “Standard / Conventional” or “Premium”.  Your insurance company will fully cover “Standard / Conventional” IOL’s.  “Premium” IOL’s will require an additional out-of-pocket expense.

  • “Standard/ Conventional” IOL: 

- Monofocal IOL:

Presently, Monofocal IOL’s are the most commonly used lenses. These lenses provide patients with one focal point.  Most commonly these lenses correct only for distance vision, unless the patient has a pre-existing astigmatism.  Patients who have had Monofocal IOL’s usually require reading glasses.
  • “Premium” IOL’s:   
- Toric IOL

benefits those people who have astigmatism.

- Multifocal IOL: for those who want to be free from glasses.

- Accommodating IOL: 

for patients who want some range of vision but do not mind wearing reading glasses for small print.

Your eye care provider will discuss with you the IOL that will best meet your goals.  

List of IOL manufactures and lens choices we offer

Alcon

  • AcrySof IQ ReSTOR IOL (Multifocal IOL)
  • AcrySof IQ Toric IOL (Astigmatism IOL)
  • AcrySof IQ (Monofocal IOL)

Abbott Medical Optics

  • Tecnis Multifocal IOL
  • Tecnis Toric IOL
  • Tecnis 1-Piece IOL

Baush & Lomb

  • Crystalens AO Lens
  • Trulign Tori IOL
  • Akreos AO Lens
  • SofPort Advanced Optics (AO) Aspheric Lens

STARR Surgical

  • Collamer IOL
  • Silicone IOL
  • Acrylic IOL
  • Toric IOL

On the day of your surgery you will report to the surgery center at your appointed time. You can expect to be there for 2-3 hours.  This is to insure proper preparation of the eye and recovery time.  Once surgery is completed you will be discharged to the care of a responsible adult to drive you home. You will have to put in a few more drops that evening and will most likely want to rest. The days after surgery you will follow up as instructed by your surgeon and continue taking your drops. You will have some restrictions on your activities for a few days.

*Even though cataract surgery is a very routine procedure, it is still surgery. Be sure to get all of your questions answered and follow all instructions.*

Below please find more detailed Pre & Post Operative Instructions 

Pre-Operative(Before Surgery)Instructions

  • Do not eat, drink, or chew anything for 8 hours prior to arriving at the surgery center. This includes water and mints, candy, gum and chewing tobacco. There are few special considerations to this guideline. Please call to speak to a Pre-Op nurse if you have any concerns.
  • Do not consume alcohol 24 hours prior to your surgeryRefrain from smoking12 hours prior to your surgery. These substances can cause you to have adverse reactions to anesthesia and medications.
  • Brush your teeth on the morning of your procedure but do not swallow any water.
  • Bathe or shower on the morning of your procedure to minimize the risk of infection.
  • Please do not wear any eye make up.
  • Wear comfortable clothing such as a shirt or blouse that doesn’t need to be pulled over your head and low-heeled shoes.
  • Leave valuables at home except what is needed to take care of any financial obligations you may have.
  • Contact lenses may not be worn during your procedure. Either leave them at home or bring a case for their safekeeping.
  • Health changes should be reported immediately to your physician, even if the changes seem minor such as fever, cough, rash, or a cold.  Please notify your physician if there is a possibility that you are pregnant.
  • Arrange for a responsible adult to drive you home and stay with you for the first 24 hours following your procedure because the effects of anesthesia and sedation will make you drowsy for that period of time.
  • Arrive at your scheduled time that was assigned by the Pre-Op nurse.  If you have not been contacted by noon the last business day before your surgery, call the Pre-Op nurse at (713) 743.7167.

Post-Operative (After Surgery) Instructions

After leaving the surgical suite, you will be moved to are covery area where our staff will care for you until you are awake and comfortable. As soon as your condition is stable and you have a responsible adult to drive you home, you will be discharged. You will be provided with instructions for home care. Please follow these instructions and be sure to ask questions if there is anything you do not understand. 

A nurse from UHCO Surgery Center will call you at home one business day after the procedure to check on your recovery. If you have not been contacted, please call and ask to speak to a Post-Op Nurse. For your well-being, we recommend that you wait at least 24 hours before you:
  • Drive or use power equipment
  • Eat a heavy meal
  • Consume alcoholic beverages
  • Take medication not approved by your physician
  • Sign important papers or make important decisions
  • Stay by yourself

Frequently Asked Questions:

 

Is it painful?

Most patients do not complain of pain but do note a slight pressure. Numbing drops are applied to the outside and injected inside the eye to alleviate the risk of pain. Pain medicine can also be given intravenously through an IV if needed.

Will I be put to sleep?

The answer is No. For surgery you are given valium to help you relax. An IV is also started in the event that you get uncomfortable in the operating room or are more anxious then the valium is able to relax.

Are both eyes done at the same time?

We do not do both eyes on the same day. There is generally a 1-2 week wait between each eye. Insurance companies will not allow both eyes to be done on the same day. Even for cash patients, we still wait 1-2 weeks between eyes so that we can make sure the first eye is healed before affecting vision of the other eye.

How long will I be there?

Plan to be at the surgery center for about 3 hours. The majority of this time is needed to get you registered and prepare your eye for surgery. The procedure only takes 15-20 minutes depending on the surgeon. Once surgery is completed, you will be in recovery for about 10 minutes.

Will I be patched after surgery?

Whether or not you will have a patch is at the surgeon’s discretion. Some surgeons patch everyone and some surgeons do not patch anyone. The purpose of the patch is to keep you from inadvertently bumping or rubbing your eye when you sleep. If your surgeon does not patch you and you feel you are at risk for bumping or rubbing your eye, feel free to ask for a patch from your post op nurse.

When can I go back to work/driving?

Most patients return to work within 1-2 days of surgery; however, returning to work is assessed on a patient by patient basis. Patients who have jobs requiring heavy lifting or who are at risk for eye injuries can be kept out of work for up to a week.  While most patients are feeling back to normal the next day, we ask that you do not drive until we are able to assess your vision.

Can I travel after surgery?

You will be able to travel anywhere from 1 day to 1 week after surgery depending on the type and location of travel. We ask that you do not travel to a foreign country for at least one week to insure the risk for infection is gone. Make sure that where ever you are traveling and your method of travel are conducive to putting in your post op drops.

Where do I park once at the surgery center?

When you arrive at the center, you will park in parking lot 2A. This is located on side and directly behind the building. Inform the parking attendant that you are here for the surgery center and he/she will let you in. You will be given a token to get back out of the gated area.

Does my friend/family member have to stay?

While we do understand that someone cannot always stay and wait for your procedure to be completed, it is preferred that your driver remain at the surgery center in the rare case of an emergency. In the even that he or she cannot, we ask that a contact phone number be left and we know the estimated time it will take them to return to the center to pick you up.