5 tips to prepare for cataract surgery

You’ll likely have many questions regarding cataract surgery, not only for your eye surgeon but also for yourself. That’s good – we want to give you all the information you need to make an informed decision. Here are a few important questions to get answered before scheduling your first procedure:

• Do you want both of your eyes done? Each eye will be assessed to determine the severity of vision impairment due to cataracts. Rarely would we do cataract surgery on both eyes on the same day, but most patients will want the surgeries done close together to minimize recovery time. Work with your ophthalmologist on a plan that works best for you.
  • If you want both eyes done, should you wait longer between the two procedures? Or stagger them close together?
  • What if you choose not to get the second eye done after the first surgery? How will that change your long-term vision goals?
• What will your insurance cover regarding cataract surgery? If you choose a type of lens that isn’t covered by your insurance, you may need to pay out of pocket. Your eye surgery team can help you choose between your best and most cost-effective options.
  • Does your insurance cover the lenses you are interested in?
  • What will you need to pay out of pocket, if anything?

Today’s intraocular lenses are better than they have ever been. Their effectiveness relies on being perfectly set in the eye, and that can only happen if we get precise measurements and photos of your eye at your preoperative exam.

Optimizing your ocular surface – namely the cornea and the conjunctiva membrane, which make up the outer layers of the eye surface – allows us to get the most accurate information.

The most common condition that can affect your ocular surface health is dry eye, which can cause abrasions on the surface of the eye along with inflammation. Many people develop dry eye with aging. It also can be caused by seasonal allergies, environmental irritants, and long-term contact lens use. You may not even realize you have dry eye, but we can see its effects when we examine your eyes.

Every cataract evaluation should also come with an evaluation for the ocular surface. Before taking eye measurements, your ophthalmologist may give you tips to optimize your ocular surface. Tips may include using over-the-counter eye lubrication or a warm compress over your eyelids for five minutes twice a day to help clear blocked oil glands.

After a few weeks, we’ll look at your eyes again to check their progress and start the more extensive preoperative exam process, such as checking the exact focusing power of the cornea and the depth between your lens and cornea.

Cataract surgery is an outpatient procedure, and your overall health influences how we plan for and perform the surgery. If you have certain health conditions, such as obesity, diabetes, high blood pressure, or a history of eye diseases or eye surgery, your doctor may need to adjust your surgical plan. For example, you might need a different type of anesthesia or additional monitoring after surgery.

Intraocular lenses are permanent, artificial lenses that can replace the eye’s natural lens to restore both near and distant vision. They can correct or improve nearsightedness, farsightedness, or astigmatism.

There are multiple intraocular lens options that may be offered to you. These include:

• Monofocal: This lens has one focusing distance, providing near, medium, or distance vision.
• Trifocal or multifocal: These types of lenses have multiple focusing distances in different areas of the lens. They are capable of bringing into focus objects that are at a far, medium, or close distance from the patient’s eye. Trifocal lenses, which can focus at all distances, are the most advanced version of these lenses that we have available.

• Extended depth of focus (EDOF) or extended range of vision: These lenses have the potential to give patients distance, medium, and even some near vision. They may have specific advantages over trifocal lenses in certain patients, such as people who have had LASIK.
• Toric: This lens has different focusing powers in different areas to correct astigmatism, which is an irregularly shaped cornea. Most monofocal, multifocal, trifocal, and EDOF lenses come in toric versions.
• Light adjustable lens (LAL): These lenses can be adjusted after placement for customized vision correction. The lens is composed of a specialized material that reacts to ultraviolet (UV) light from a special machine. Each session takes just a few minutes of exposure to change the lens shape and how well it focuses light. We can direct the light to adjust different parts of the lens, making it more or less curved depending on what you need to see better.
• Small aperture: These unique lenses use the pinhole effect to provide a range of vision while correcting for irregular astigmatism from corneal disease.

There are limitations and trade-offs for any lens option. For example, some lenses may provide a better range of vision but have lower contrast or color sensitivity. LALs can be adjusted after placement, but you’ll have to attend multiple appointments to do so with a longer recovery period.

You won’t have to decide on a lens right away. Most people like to go home, think about it, and look over their finances and coverage. Once you’ve decided, we can schedule your surgery.

Following instructions from your ophthalmologist is essential to improving your vision with cataract surgery. A couple weeks before the procedure, your health care team will reach out with a pre-surgery care plan that may include:

• Avoiding certain medications
• Not wearing contact lenses
• Not applying makeup, lotions, or perfumes
• Using prescribed antibiotic drops
• Not eating solid food for a set number of hours before surgery
• Arranging for someone to drive you to and from your surgery

After your procedure, you’ll get a customized recovery plan. For the first week after surgery, you should not rub your eyes or put water directly in the eye. While the rate of infection after eye surgery is low – less than 0.1% in the U.S. – it is still important to prevent this devastating consequence.

You’ll also need to avoid strenuous exercise and movements that involve bending over or lifting more than 15 pounds in the first few weeks after surgery. These activities can temporarily increase pressure in the eyes and possibly damage the surgical incision.

Your eye will need time to adjust to the new lens – most people notice improvements within the first couple of weeks. Full healing can take up to three months, depending on your unique eye tissues, lens, and surgery.

If you’re considering cataract surgery, talk with an ophthalmologist. We want to hear your questions, and we’ll provide all the information and answers you need to make an informed decision. Your vision is important, and we’re honored to give you the best possible outcomes.