Cataract Surgery
Over fifty percent of people over the age of 60, and quite a few younger than that, experience vision loss from cataracts. Currently there is no medical treatment to reverse or prevent the development of cataracts. Once they form, the only way to see clearly again is to have them removed from within the eye by doing outpatient surgery.
In your parents' or grandparents' day, cataract surgery was considered risky, required a lengthy hospital stay, and was usually postponed until the "cataract got ripe", a term no longer used today. Most of the decision to do surgery rests with the patient, based on their symptoms, and on advice from your eye doctor. Cataract surgery is performed on an outpatient basis and takes only a few minutes. It is now one of the most common and successful medical procedures performed, in the hands of a skilled surgeon. Cataract surgery is for those who:
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believe that their quality of life has been impaired by poor vision, glare, distortion of colors, inability to read or drive, etc.
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have been diagnosed with cataracts by their doctor of optometry or other doctor in the past
What to expect on surgery day: (also refer to Frequently Asked Questions by scrolling to the bottom of this page!)
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You will arrive at the surgery center about an hour or two prior to your procedure, depending on the testing that needs to be done. Some patients will require a complete eye exam if they have not been seen at Omni before surgery day. Other patients who are coming in to have their second eye done will need a simple vision check of the operated eye.
We tell patients to plan on spending 3 to 4 hours at the surgery center. You must bring a driver with you on the day of surgery, or surgery will be cancelled.
Once you have been checked in to the surgery center, your medical history will be reviewed and you will be prepped for surgery. You will be offered a sedative under your tongue to help you relax. The area around your eyes will be cleaned and a sterile drape applied around your eye.
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Eye drops (a local anesthetic) will be used to numb your eye. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.
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Your eye will be completely numbed before the procedure.
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A very small incision will be made and a tiny ultrasonic probe will be used to break up the cataract into microscopic particles using high-energy sound waves. This is called phacoemulsification.
The cataract particles will be gently suctioned away. Then, a folded intra-ocular lens (IOL) will be inserted through the micro-incision, then unfolded and locked into permanent position. The small incision is "self-sealing" and usually requires no stitches. It remains tightly closed by the natural outward pressure within the eye. This type of incision heals fast and provides a much more comfortable recuperation.
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Intra-Ocular Lens replaces the natural lens of the eye.
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The IOL is placed inside the capsular bag of the eye.
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If your eye has pre-existing astigmatism, you will be offered a TORIC IOL, a lens placed inside your eye to correct for astigmatism. The surgeon can sometimes reduce astigmatism based on the location of the incision. He may also elect to make micro-incisions in the cornea to reduce your astigmatism. These are called LRIs or limbal relaxing incisions. This is not as predictable a procedure as the Toric IOL, and does not correct nearly as much astigmatism.
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Pre-existing astigmatism can be treated with limbal relaxing incisions.
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During a 20 minute stay in the recovery area, you will be instructed on the care of your eye and the use of eyedrops. You will go home soon after and relax for the rest of the day. Everyone heals at different rates, but many patients report improvement in their vision almost immediately after the procedure. Most patients return to their normal activities within a day or two. The only limitation is heavy lifting. In most cases your referring Doctor of Optometry will see you for the one-day postop visit. You will then be seen again in 1 week and in 1 month. Glasses will be changed at the appropriate time by your optometrist. Occasionally there are insurance issues that require that you be seen at Omni for your post-operative care.
Testimonials:
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"After dark, when I was driving, the dashboard lights didn't seem to be bright enough. My wife said, 'Sam, the lights are bright enough. There is something wrong with your eyes.'"
- Sam Origlio, M.D. (Retired Surgeon)
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Realistic expectations:
The decision to have cataract surgery is an important one that you will make along with your Doctor of Optometry. The goal of any vision restoration procedure is to improve your vision. Once removed, cataracts will not grow back. Months after surgery, some patients may experience clouding of vision similiar to when the cataract developed. This could be a sign of Posterior Capsular Opacification, a clouding of the thin tissue, called the capsular bag, that holds the intra-ocular lens. In most cases, a laser is used to painlessly open the clouded capsule and restore clear vision with a procedure called a capsulotomy.
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The capsular bag may become cloudy in the future.
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Serious complications with cataract surgery are extremely rare. It is a safe, effective and permanent procedure, but like any surgical procedure, it does have some risks. Going to an eye specialist experienced with the procedure can significantly minimize the risks involved with cataract surgery.
After a thorough eye exam, you and your doctor will determine if cataract surgery is an option for you. You will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.
FREQUENTLY ASKED QUESTIONS
How are the eyes numbed, and how long does the eye stay numb?
In most cases, a topical drop is used. The anesthetic (numbing) effect wears off within 15-20 minutes.
Do you do the surgery with laser?
No, currently no one does cataract surgery with laser. In the event you develop a clouding of the membrane that holds the artificial lens in place, a laser can be used to clear that up.
The doctors at Omni use a special ultrasound instrument that breaks up the cataract inside the eye, thereby allowing for a very small rather than large incision and usually no stitches. Laser Technology will be available in the near future that will assist in taking out the cataract.
How long does the surgery take?
At Omni, typically about 7 to 15 minutes, depending on the type of cataract that you have, although you will be in the surgery center for several hours. Many surgeons who only do a few cataracts a week typically take quite a bit longer than this.
Will I have pain afterward?
Usually not, although some people notice a scratchy dry feeling for a week or so, almost as if there is something in the eye. Pain after surgery is very unusual and your doctor should be made aware of it right away, even after hours.
How long does it take for the eye to heal?
Complete healing takes place in about a month
Are there any restrictions after surgery?
No lifting over 20 pounds, and no golf or swimming for several weeks.
When can I resume my work and daily household chores?
Immediately after the surgery
How long must I wait before I have the second eye done?
2 weeks
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