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WHAT TO EXPECT WITH CATARACT SURGERY
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Before surgery

Complete eye examination to determine your glasses prescription (refraction), measurement of your vision with and without glasses (visual acuity), evaluation of eyelids, pupils, eye muscle balance, and confrontational visual fields, measurement of the pressures inside your eye (tonometry), measurement of the curvature of your cornea (keratometry), microscopic examination of the anterior segment (cornea, anterior chamber, iris, cataract, and anterior vitreous) of your eye (slit-lamp examination), and a dilated examination of the retina and vitreous.

Medical history We will ask about your medical conditions, medication usage, and allergies. Please let us know if you have ever taken medications such as Flomax or other drugs to help with urination.

Calculations to determine your IOL power. Once you have decided to have cataract surgery, Calculations to determine your IOL power with the Lenstar 900 will be performed. This is one of the most accurate method for measuring the parts of the eye to determine the IOL power for your eye. It also has advanced formulas that improve IOL power calculation in eyes that have had previous refractive surgery (RK, PRK, & LASIK).

Patients who decide on a premium IOL (presbyopia-correcting or astigmatism-correcting IOL) will have additional tests.The Nidek OPD 3 will be used to measure corneal wavefront aberrations, topography and keratometry. It also measures the pupil diameter for light and dark. Ocular dominance will be determined. The intraocular structures are measured using the Optovue Avanti widefield OCT. This is used to image the cornea, optic nerve and macula. This is done at a level that cannot be seen by conventional tool.

PREVIOUS REFRACTIVE SURGERY (RK,PRK, LASIK)An important measurement to determine the IOL power depends on corneal measurements. The standard IOL formulas can not predict the correct IOL power due to the changes in the cornea. We use the formulas for astigmatism and previous refractive(RK,PRK, &LASIK) surgery from the Lenstar 900, the Avantiís Total Corneal Power which measures the corneal refractive power, and Nidek OPD3 corneal power after refractive surgery. The different results are entered into a formula to get the best IOL power.

Preparing for surgery

You will need a medical clearance from your family physician within 30 days of surgery. This includes a history, physical, CBC (complete blood count), EKG (if you have had significant cardiac disease), and chest X-ray (if you have had significant lung disease). On the night before surgery, do not eat or drink after midnight. Postpone your diabetic medications until after surgery or reduce the dose if surgery is in the late morning or afternoon. Continue to take other medications prior to surgery, including aspirin. You may take your medications with a little bit of water.

What to wear: Clean clothes, loose tops, short sleeve top, no dresses, no body suits, no turtlenecks. Do not wear eye makeup, facial moisturizer, perfume, cologne, or body mist.

Location: Surgical Specialty, 9001 Wishire Blvd. #100, Beverly Hills, CA 90211

Arrival: Arrive one hour prior to surgery. Upon arrival, you will complete surgical center registration forms. Bring insurance cards with you. Be prepared to pay co-pays or any other out of pocket expenses.

Length of stay: Count on being at the facility for up to two hours. You will need someone to take you home. The surgery center will NOT release you without a companion. You will not be released to a cab driver.

Surgery:

  • Patients who have decided on Laser Assisted Cataract Surgery are first brought into the Femtosecond laser room where the surgical incisions, astigmatism correction, capsulorhexis and division of the lens are done before being taken into the surgical suite.
  • In the surgical suite, an anesthesiologist will provide a mild sedative to make your surgery more comfortable and to relax you.
  • To remove the cataract, Dr. Oyakawa makes microscopic incisions or opens the incision in Laser Assisted Cataract Surgery eyes and gently removes the cataract in a procedure called phacoemulsification.
  • Next, the IOL is inserted through the same microscopic incision and placed into the lens capsule of your eye where the natural lens was located. The procedure usually takes only 15 to 30 minutes.
  • Today, cataract removal is generally performed as an outpatient procedure under topical anesthesia. Dr. Oyakawa uses topical anesthesia in over 99% of patients, and they leave the operating room without needing an eye patch or shield.
  • Because this procedure is performed through a microscopic incision, the eye usually seals itself without stitches.
  • Following the procedure, most people return home within an hour or so. Vision is improved immediately in most cases. However, vision usually continues to improve in the weeks following the procedure until you achieve your best-possible vision.

After surgery: Your eye will be examined the same or next day and then at intervals determined by Dr. Oyakawa.

Eye drops: You started some of these drops a few days before surgery. The antibiotic drop you started will be continued for two more weeks. The NSAID and steroid drops will be used about four to six weeks, depending on your individual rate of healing.

Back to work: You may return to work the next day after surgery. Reading restrictions apply to Crystalens implants. You must use the reader provided for two weeks.

Surgery on your second eye: If you need cataract surgery in both eyes, the second eye can be done one to two weeks later.

Reading: You may start reading with multifocal presbyopia-correcting IOLS, and with reader with monofocal IOLs. Reading restrictions do apply to Crystalens® implants. You must use the reader provided for two weeks. Failure to do so may result in lens focused for near (mild near-sightedness).

Exercise: You may resume physical activities in as soon as one day depending on your surgery (ask Dr. Oyakawa). DO NOT get sweat into your eyes.

Precautions: Do not allow water to flow directly onto your face or directly at your eyes for 10 days after surgery.
Do not wear makeup, moisturizer, perfume or cologne for five days.
Do not swim or use jacuzzis or saunas for five days.
Do not use hair chemicals (color treatments or harsh solutions) for 10 days.

Pets: Please be sure to wash linens after your surgery. Please DO NOT sleep with pets. Their fine hair may get into your eyes.

Normal healing: You may experience: scratchiness, few areas of redness, foreign body sensation, mild tenderness to touch, and fluctuating vision.

Glasses: Glasses for standard cataract surgery will be prescribed by Dr. Oyakawa or your comanaging doctor about a week after medications are stopped.

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