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Cataract surgery not as bad as many believe

By Sasha L Radford, OD

“Hopefully I’ll die before I need cataract surgery.”

The number of patients that have said this astounds me. It’s often a challenge to convince patients how quick and painless cataract surgery and its recovery can be. Often patients are so apprehensive they think they’d rather endure poor vision than have the procedure.

In last month’s column, I described a lady who thought her favorite rug was fading but it turned out that cataracts were the cause of her decreased color perception. Of course, after the cataracts were removed she wished she had done it sooner. And I have to say, more patients have told me that they shouldn’t have waited than have told me they’d rather die first than have their cataracts removed.

So what exactly is involved in cataract surgery? Do they have to take your eye out and put it back in? (No, but one patient I had firmly believed that’s how his surgeon did it!) Will you be asleep? Is it all done with lasers? How long until you can resume normal activities?

A cataract is a clouding or opacity of the natural crystalline lens which is located just behind the iris and pupil. It’s similar to having a big smudge on your glasses that can’t be removed; this is why stronger glasses aren’t helpful. The essence of cataract surgery is removing the cloudy lens and replacing it with a synthetic implant.

First of all, most people are awake during cataract surgery and general anesthesia is only rarely necessary. If both eyes have cataracts, the surgeries will be performed on different days, usually a week or two apart. In most cases, the eye is numbed with drops; there are usually no needles or stitches used. The incisions to remove the lens and place the implant are so small they seal themselves and heal very quickly.

Parts of cataract surgery can be done with a laser such as making the corneal incisions and creating an opening for the lens to be removed. Other parts of the procedure cannot be done with lasers since the lens must physically be removed from the eye and an implant inserted in its place.

What is the implant for? The natural lens makes up approximately one third the power of the eye. When it is removed, an implant is placed to provide that needed focusing power; otherwise very thick spectacle lenses would be needed. The marvelous thing about cataract surgery is that the surgeon can also correct a patient’s distance vision so that glasses are only needed for reading. Alternatively, if reading glasses are undesirable, monovision – focusing one eye to see things well far away and the other eye focused up close for reading – is an option.

There are also premium lens implants that can correct astigmatism or provide vision close up and far away simultaneously with a multifocal design. This is an excellent way to reduce or even eliminate your dependence on glasses and some patients elect to have this procedure even before cataracts need to be removed. The use of premium implants is combined with a laser-assisted surgical procedure to fine tune vision as needed.

Recovery from cataract surgery is quite straightforward and involves the use of eye drops for a few weeks to prevent infection and inflammation and to speed the healing process.

Dr Scott Pinter from Eye Surgical Associates routinely performs cataract surgery for many of my patients. After the procedure, he cautions patients against rubbing the eyes and heavy lifting during the first week and patients should not swim or wear eye makeup for two weeks following surgery. Dr Pinter also says most patients are able to resume their routine activities the day after the procedure and those receiving premium lenses to correct vision are usually able to work and drive the next day.

It’s normal to be apprehensive about any surgical procedure but now it should be clear that cataract surgery is not such a dim prospect after all.