Cataract surgery today is a quick and painless procedure, taking less than 20 minutes. The procedure is done as an outpatient in either a hospital or surgical center. Cataract surgery at Madison Medical Eye Care is generally done without the need for shots around the eye, stitches, or patches afterward. While the procedure gets quicker and safer all the time, the newest advancements in cataract surgery involve the types of implants inserted at the time of surgery.
During cataract surgery, the natural lens is liquefied with a tiny ultrasound machine and removed with gentle suction. We then insert a small plastic implant to restore your vision. Without an implant, you would require thick glasses or contact lenses after surgery in order to see clearly, as was the case in the past. We have long been able to correct distance vision with these implants using a Standard implant, but now can correct for astigmatism with Toric implants and even for reading with Multi-focal implants.
Which implant is right for you depends on your eyes and your visual needs:
WHAT EXACTLY IS A CATARACT?
A cataract is a clouding of your natural lens, located behind your pupil. The lens contains protein that degenerates with age. When you are about 45 years old, this change in the lens protein makes the natural lens firmer and that's why reading glasses are needed at that time. Later, the lens protein begins to change color which makes the lens cloudy. The result is a cataract and blurred vision.
HOW CAN I TELL IF I HAVE A CATARACT?
You can't really tell if you have a cataract without a complete examination by an ophthalmologist or optometrist. The symptoms of a cataract are a gradual blurring of your vision, mainly for distance, and problems seeing at night due to glare or halos around lights. But blurred vision can have many causes, thus the need for the examination. Cataracts usually develop slowly so any rapid change in vision, for instance overnight, is probably due to a more serious problem and requires immediate attention.
WHAT IS CATARACT SURGERY LIKE?
Cataract surgery is an outpatient procedure that usually takes about 10 or 15 minutes. You are at the surgical facility for 3 or 4 hours, however, to prepare for the surgery and recover. Be sure to arrange for a ride home afterward because we do use mild IV sedation.
Once in the operating room, you lie on your back and look at a bright light during the procedure. Generally, no shots, stitches, or patches are required. You are relaxed but can hear everything that is going on during the procedure. Our doctors will explain what is happening and where you are supposed to look. It is important that you not move or talk during the procedure - keep looking at the light. Cataract surgery is not generally painful during the procedure or afterward.
After the surgery, your vision is a bit blurry but improves over the next several hours. There is generally no patch over the eye. You can do just about anything except drive for the rest of the day, but might feel more comfortable just going home and relaxing. The use of eye drops needed after surgery will be explained to you along with your restrictions, which include not lifting anything over 30 pounds, pushing on the eye, or swimming for two weeks after surgery.
WHAT HAPPENS, STEP BY STEP, IF I DECIDE TO HAVE CATARACT SURGERY?
Once we determine that you do have a cataract, our doctors will thoroughly explain the procedure and discuss your options for lens implants. Then our surgical coordinator will find a date for your surgery and a time for you to return to be measured for the lens implant. Your post-operative appointments will also be arranged. You will be asked to call your primary care doctor to schedule a pre-operative history and physical examination.
When you return for the lens measurements, which takes about an hour, we will give you a kit containing eye drops and explain how they are to be used. On the day of surgery, you will be asked to change into a hospital gown. You may leave your undergarments on. An IV will be started and you will be placed on a gurney. Most of our surgery takes place at Columbia-St. Mary's Hospital in Mequon which is the only location offering cataract surgery in Ozaukee County.
Once in the operating room, you will be given a mild sedative through the IV line. You will lie on your back and concentrate on looking at the bright light in front of you. We ask you not to talk or move unless you are experiencing pain or feel like you need to cough. Should any of these things occur, you let us know without moving much and we take care of the problem. You are in the operating room about 30 minutes and the procedure takes about 10 to 15 minutes.
Afterward, you return to your family or waiting friends in your private room in Day Surgery. You will be able to go home in 30 to 45 minutes after the surgery.
STANDARD, MULTI-FOCAL, TORIC IMPLANTS - WHICH ONE IS BEST?
Your choice of implant at the time of cataract surgery depends on your eyes and how you feel about glasses. You only have cataract surgery once in each eye so this decision will affect the way you see for the rest of your life. Even if you have not minded glasses in the past, you should at least imagine the possibility of not being so dependent on them after surgery with the use of Multi-focal or Toric implants. While there are three types of implants: Standard, Multi-focal, and Toric, not everyone is a candidate for them. We will be sure to discuss your implant options at the time of your cataract consultation.
The Standard Implant Option
If you love bifocal glasses, then stay with the Standard implant. But even if you haven’t really minded glasses in the past, you have to admit that they get in the way, cost money, and require that you look down to read. Furthermore, using a computer with bifocals can lead to neck pain. So just because you have always had glasses, doesn't mean you shouldn't at least consider the other options.
The Multi-Focal Implant Option
The Multi-focal implants allow you to see well far away for driving, near for reading, and at intermediate distances for computers or countertop activities after surgery without glasses. With these implants, you could play golf with over-the-counter sunglasses and keep score without looking for reading glasses. While we don’t guarantee that you would never use glasses with these implants, it would be rare. This freedom from glasses makes your life simpler and really “turns back the clock” to a time when you did not need glasses. We have many patients who are actually now wanting their cataracts to worsen so they can take advantage of these Multi-focal implants! They turn something that is potentially negative, a cataract, into something positive: relative freedom from glasses.
The Toric Implant Option
If you have astigmatism or a curved shape to the front of your eyes, you could take advantage of the Toric implants. They compensate for your astigmatism so you have great distance vision without glasses after surgery. You would still need glasses to read but could probably get by with over-the-counter reading glasses. You would no longer have to hassle with thick bifocal glasses and make sure they were adjusted just right to see well.
