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Cataract Surgery or Lens Implant/Refractive Lens Exchange FAQs

Q. What causes a cataract?
A.
Cataract formation is a natural aging process, which can increase with certain medical conditions such as diabetes and the use of certain drugs such as steroids. Other risk factors include smoking, air pollution, heavy alcohol consumption, increase salt use, and radiation such as ultraviolet light. Some doctors feel a diet high in antioxidants may slow cataract development.

As we age, the lens looses flexibility. The first significant sign is the need for reading glasses, called presbyopia. From this point, the lens continues to harden and then becomes cloudy decreasing vision. At first, the decrease in vision from cataract can be ameliorated with a change in glasses. Eventually changing glasses will no longer improve vision, and surgery will be needed to restore vision.

Q. What are symptoms of cataract?
A.
A decease in vision, not being able to see signs on the freeway until close is common, glare from bright lights or the sun, halos around lights at night, double vision from one eye, change in color of objects (we have seen patients who where planning on buying a new color TV due to poor colors and after cataract surgery, they realized it was their cataracts), difficulty with prolonged reading, etc.

Q. How are cataracts diagnosed?
A.
A complete eye exam is done to eliminate other causes of decrease in vision such as macular problem from diabetes or age-related macular degeneration, glaucoma, corneal diseases, optic nerve problems, etc.

Q. Is surgery the only treatment for cataract surgery?
A.
Yes, cataracts can not be cured by medication or drops.

Q. Do I have to wait until my cataracts are ripe?
A.
This is an outdated statement and was recommended for an older technique not commonly used today. Current techniques use phacoemulsification (ultrasound) and small incision. Waiting until the cataract is ripe can increase untrasound time during surgery and increase complications.

Q. Is general anesthesia used for cataract surgery?
A.
No, except for rare situations. Most cataract surgery are done with topical and intracameral anesthesia. Numbing drops are used to numb the eye. An incision is made into the eye and additional anesthesia in instilled around the cataract. An anesthesiologist also administers relaxing medications during the surgery to keep you comfortable.

Q. How soon will I recover after cataract surgery?
A.
Vision will improve almost immediately for most patients. However, even without problems some patients take a fews weeks for vision to be restored. This is dependent on age and general health.

Q. Are cataract and refractive lens exchange surgeries safe?
A. Yes, but as with any surgery, there are risks. The overall success of cataract surgery is 95% improvement in vision.

Q. What are intraoperative complications of cataract surgery?
A.
Cataract surgery is one of the most successful procedures in all of medicine. However, complications do occur. Intraocular complications related to retrobulbar anesthesthesia include globe perforation, optic nerve damage, and retrobulbar hemmmorhage. These complications are avoided with topical and intracameral anesthesia. The most common intraoperative complications (total about 2%) include: positive vitreous pressure, posterior capsulare rupture, zonular dialysis, vitreous loss, retained lens fragments,descement's detachment, inability to implant the planned IOL, intraocular hemorrhage, etc.

Q. What are the postoperative complications of cataract surgery?
A.
Even if no surgical complications occur, postoperative can occur. Temporary elevation of intraocular presuure, macular edema, corneal edema, infection, hemorrhage, retinal detachment, ptosis etc. It is important to follow all postoperative instruction, keep all your appointments and call the office if you have a change in vision, pain, or redness.

Q. Is 20/20 vision guaranteed after surgery?
A.
No surgical procedure can be guaranteed. The good visual acuity will depend on having a relatively normal eye besides the cataract.

Q. What if I blink?
A.
An eyelid retainer is used during surgery to prevent you from blinking.

Q. Will I need glasses after cataract surgery?
A.
Yes, if you have standard cataract surgery. Presbyopia or astigmatism cataract surgery will decrease the need for glasses.

Q. When can I drive?
A.
Depends on how fast your eye heals, the level of astigmatism and the vision in the other eye. Many patients will see well enough to drive a few hours after surgery. Most patient will see well enough to drive in a few days. You will have to wait unitl you get glasses if significant astigmatism is present and not corrected during surgery. Your individual situation should be discussed with the doctor.

Q. When can I return to work?
A.
Most patients can return to work the day after surgery. Appropriate precautions should be taken if the work environment is dirty or dusty.

Q. When can I shower and wash my face?
A.
The next day. Avoid getting soap and water in the eyes.

Q. When can I resume my eyelid hygiene?
A.
Avoid cleaning your lashes for 15 days.

Q. How soon can I rub my eyes?
A.
The flap continues to heal for many months. For the first few weeks, only use light pressure on the eyes. After a few months you may rub your eyes in a normal gentle manner.

Q. When can I go swimming, scuba diving or use a hot tub?
A.
15 days.

Q. When can I fly in an airplane?
A.
The next day, but you will need to use more artificial tears since the cabin air tends to be much drier.

Q. When can I play golf?
A.
In three days. Avoid getting sweat in your eyes and wash your face prior to playing golf.

Q. How soon can I exercise?
A.
The next day. Avoid getting sweat in your eyes and wash your face prior to and after exercising.

Q. When can I wear eye makeup?
A.
After 15 days minimum.

Q. Does a cataract come back?
A.
A cataract does not reform. However, a membrane (the posterior capsule and part of the anterior capsule of the cataract is not removed) is used to secure the IOL. The posterior capsule becomes opaque or reduces vision in 20% to 50% of cases. This can be lasered (YAG capsulotomy) in the office to restore vision. Presbyopia correction IOLs have higher incidence for the need of this type of laser for better vision.

Q. Can I wear glasses or contact lenses after surgery?
A.
The goal of refractive surgery is to decrease or eliminate the need for glasses or contact lenses. However, a few monovision patients use glasses for night driving or for prolonged computer work or reading. Some monovision patients use one disposable contact lens in their near eye for good binocular vision during sports, such as tennis. Glasses or contact lens can be used while the eye stabilizes prior to enhancement.

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