What You Need to Know About Cataract Surgery

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Your eyes contain a small disc, known as a lens, that helps focus light on your retina so you can see. The lens is usually clear but can develop cloudy patches called cataracts. This is most common as you get older. While you may not notice it initially, over time, cataracts can cause your vision to become blurry and make daily tasks difficult. When it reaches this point, your eye doctor may suggest having cataract surgery. While any surgery is serious business, cataract surgery is not too risky and has a very high success rate. It’s also an outpatient surgery, so, most of the time, no hospital stay is necessary. Here is everything you need to know about cataract surgery.

What Is Cataract Surgery?

Cataract surgery is a common procedure. The clouded lens of your eye is removed and replaced with a clear artificial lens (known as an intraocular lens) to improve your vision. It is performed by an eye doctor (ophthalmologist), usually as an outpatient procedure. This means you have the surgery in a day and return home rather than a hospital where you are likely to stay overnight.

Do I Need Cataract Surgery?

If your vision starts to change or feel blurry, you should see an eye doctor for a vision test. The doctor will examine your eye and determine what the problem is. Some people say that having cataracts is like looking at the world through a dusty window or heavy fog.

If you develop cataracts, your doctor will advise how advanced it is and if they recommend surgery. But, it is up to you whether or not you want to get the surgery. A cataract in itself is not harmful and is, in fact, a normal part of the aging process. Everyone at some point will likely develop cataracts, which can slowly get worse over time. 

However, it is only when it begins to affect your vision and your ability to do daily tasks or leisure activities that you might want to consider having surgery to remove the cataracts. So, if you feel it is not impacting your life too much, you may choose to hold off on surgery. Take time to consider your options while monitoring the situation with regular check-ups. 

In most cases, waiting will not cause harm to your eye. If your vision is still quite good, you may not need cataract surgery for many years, if at all. If your vision is poor, ultimately, the only way to improve your eyesight will be to remove the cloudy lens and replace it with a new artificial one through cataract surgery.

Another reason cataract surgery may be necessary is if you have another eye condition, like age-related macular degeneration (AMD) or diabetic retinopathy. Your doctor needs to see the back of your eye to manage the condition. This will usually involve only temporary removal of the lens and is also a fairly straightforward procedure.

Cost of Cataract Surgery and Medicare Coverage

Cataract surgery costs can be between $3,500 and $7,000 per eye. Fortunately, Medicare and private insurance cover most of these costs. There are some exceptions to this where you may have out-of-pocket expenses like if you:

Require special types of replacement artificial lenses which cost more

Do not meet the age or vision requirements, and you choose to have cataract surgery early before your vision has substantially deteriorated. This is viewed as an elective procedure.

How Long Does it Take?

Cataract surgery is a straightforward outpatient procedure, so you will be able to go home the same day. The procedure is quick and painless and usually takes under an hour.

If you have cataracts in both eyes, surgery is usually performed on one eye at a time, 1 to 3 months apart. This allows you to use one eye while the other heals during recovery. However, suppose you have a low risk of complications. In that case, you may have the option for both eyes to be treated on the same day in a procedure known as immediate sequential bilateral cataract surgery.

Preparation For Cataract Surgery

First, you talk to a specialist for an in-depth assessment of your eyesight. This is a good opportunity for you to discuss your particular situation, what the surgery will involve, and ask any questions you may have.  

About a week or so before the surgery, your doctor will perform a painless ultrasound test to measure the size and shape of your eye to determine the correct type of replacement lens for you. Your doctor may also advise you to temporarily stop taking some medications that may interfere with the procedure by increasing your risk of bleeding. At this point, you should also make sure to arrange for someone to take you to and from the surgery on the day, as you will be unable to drive yourself home.

On the day before the surgery, be prepared to have a period of fasting where you do not eat anything for 6-12 hours. Your doctor will provide specific instructions about this. It’s important to follow them as it will depend on the type of anesthetic you get and what is necessary to reduce the risk of complications during surgery. If you do not follow these instructions, your doctor could postpone your surgery.

What to Expect During Cataract Surgery

Photo Courtesy: DragonImages/iStock

Your eyes contain a small disc, known as a lens, that helps focus light on your retina so you can see. The lens is usually clear but can develop cloudy patches called cataracts. This is most common as you get older. While you may not notice it initially, over time, cataracts can cause your vision to become blurry and make daily tasks difficult. When it reaches this point, your eye doctor may suggest having cataract surgery. While any surgery is serious business, cataract surgery is not too risky and has a very high success rate. It’s also an outpatient surgery, so, most of the time, no hospital stay is necessary. Here is everything you need to know about cataract surgery.

What Is Cataract Surgery?

Cataract surgery is a common procedure. The clouded lens of your eye is removed and replaced with a clear artificial lens (known as an intraocular lens) to improve your vision. It is performed by an eye doctor (ophthalmologist), usually as an outpatient procedure. This means you have the surgery in a day and return home rather than a hospital where you are likely to stay overnight.

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Do I Need Cataract Surgery?

If your vision starts to change or feel blurry, you should see an eye doctor for a vision test. The doctor will examine your eye and determine what the problem is. Some people say that having cataracts is like looking at the world through a dusty window or heavy fog.

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If you develop cataracts, your doctor will advise how advanced it is and if they recommend surgery. But, it is up to you whether or not you want to get the surgery. A cataract in itself is not harmful and is, in fact, a normal part of the aging process. Everyone at some point will likely develop cataracts, which can slowly get worse over time. 

However, it is only when it begins to affect your vision and your ability to do daily tasks or leisure activities that you might want to consider having surgery to remove the cataracts. So, if you feel it is not impacting your life too much, you may choose to hold off on surgery. Take time to consider your options while monitoring the situation with regular check-ups. 

In most cases, waiting will not cause harm to your eye. If your vision is still quite good, you may not need cataract surgery for many years, if at all. If your vision is poor, ultimately, the only way to improve your eyesight will be to remove the cloudy lens and replace it with a new artificial one through cataract surgery.

Another reason cataract surgery may be necessary is if you have another eye condition, like age-related macular degeneration (AMD) or diabetic retinopathy. Your doctor needs to see the back of your eye to manage the condition. This will usually involve only temporary removal of the lens and is also a fairly straightforward procedure.

Cost of Cataract Surgery and Medicare Coverage

Cataract surgery costs can be between $3,500 and $7,000 per eye. Fortunately, Medicare and private insurance cover most of these costs. There are some exceptions to this where you may have out-of-pocket expenses like if you:

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Require special types of replacement artificial lenses which cost more

Do not meet the age or vision requirements, and you choose to have cataract surgery early before your vision has substantially deteriorated. This is viewed as an elective procedure.

How Long Does it Take?

Cataract surgery is a straightforward outpatient procedure, so you will be able to go home the same day. The procedure is quick and painless and usually takes under an hour.

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If you have cataracts in both eyes, surgery is usually performed on one eye at a time, 1 to 3 months apart. This allows you to use one eye while the other heals during recovery. However, suppose you have a low risk of complications. In that case, you may have the option for both eyes to be treated on the same day in a procedure known as immediate sequential bilateral cataract surgery.

Preparation For Cataract Surgery

First, you talk to a specialist for an in-depth assessment of your eyesight. This is a good opportunity for you to discuss your particular situation, what the surgery will involve, and ask any questions you may have.  

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About a week or so before the surgery, your doctor will perform a painless ultrasound test to measure the size and shape of your eye to determine the correct type of replacement lens for you. Your doctor may also advise you to temporarily stop taking some medications that may interfere with the procedure by increasing your risk of bleeding. At this point, you should also make sure to arrange for someone to take you to and from the surgery on the day, as you will be unable to drive yourself home.

On the day before the surgery, be prepared to have a period of fasting where you do not eat anything for 6-12 hours. Your doctor will provide specific instructions about this. It’s important to follow them as it will depend on the type of anesthetic you get and what is necessary to reduce the risk of complications during surgery. If you do not follow these instructions, your doctor could postpone your surgery.

What to Expect During Cataract Surgery

At the start of the procedure, your doctor will administer special eye drops to dilate your pupil. You will then get an injection around the eye with a local anesthetic that has a numbing effect and will keep you from feeling anything while the doctor works on your eye. You may also get a sedative to help you relax, but you will stay awake during the surgery. You will not be able to see what the doctor is doing during the procedure but may still notice bright lights, colors, and movements.

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Your doctor will start the procedure by looking through a special microscope to get a close-up view of your eye. They will then use small tools to make a tiny cut in the side of your eye. They will either remove the lens in one piece (extracapsular extraction) or use ultrasound probes to break up the lens into small pieces and take them out (phacoemulsification). Once the doctor removes the old lens, they will place the new clear artificial lens (intraocular lens) into the empty lens capsule.

You will need to stay relatively still for about 10-15 minutes, so if you need to move or adjust your position, let the doctor know. After the doctor puts in the new lens, a shield will be placed over your eye. The doctor will ask you to rest in a recovery area of the clinic for around 30 minutes. The doctor or assistant will check on you one final time to ensure there are no problems before releasing you to go home. You won’t be able to drive yourself, so make sure to arrange for someone to pick you up.

Recovery: Dos and Don’ts after Cataract Surgery

Immediately after your surgery, your eye may feel sensitive, uncomfortable, or a bit itchy. Your vision may also be a bit blurry at first. You should start feeling better in a day or two once your eye begins healing and adjusting to the new lens. You should notice that you can see more clearly, and some people also notice that colors appear brighter.

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The healing process can take up to 8 weeks. Particularly in the first few days and weeks after your surgery, there are some things you should do and avoid doing to ensure a fast and successful recovery.

Do:

  • Follow your doctors’ instructions for caring for your eye
  • Use eye drops as directed if your doctor prescribes it
  • Wear a protective eye shield or glasses for a few days after your surgery as recommended by your doctor
  • Go to all your follow-up appointments where your doctor can check if your eye is healing properly

Don’t:

  • Touch, rub, or push on your eye
  • Do any activities that require you to bend over
  • Over-exert yourself with strenuous activity or by lifting heavy things
  • Go swimming
  • Drive until you can see properly again and your doctor advises it is safe

Side Effects & Risks of Cataract Surgery

Cataract surgery is a common, safe, and effective surgery with a very high success rate. About 9 of 10 people will have noticeable improvement in their vision after cataract surgery. Some people may experience some minor side effects following the surgery, including:

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  • Bloodshot or red eyes
  • Your eyes feeling sensitive to light
  • Your eyes feeling dry or like there is something in them
  • Seeing squiggly lines (floaters) or flashes of light in your vision
  • Nausea or disorientation

You should report any of these side effects to your doctor at the follow-up appointments.

Risks

It is uncommon to experience serious complications following cataract surgery (estimated at around 1 in 50 cases). However, as with any surgery, there are some risks involved. Some of the less serious complications include:

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  • Inflammation of the eye
  • Infection
  • Swelling
  • Bleeding

Occasionally, more serious problems may occur, such as:

  • Damage to other parts of the eye
  • A drooping eyelid
  • Unusual pressure buildup in the eye
  • Dislocation of the lens
  • A detached retina
  • Glaucoma
  • More cataracts

Many of these complications are manageable; your doctor can treat them with medicine or surgery if caught early. So, follow your doctors’ advice, go to all your check-up appointments, and notify your doctor if you notice anything unexpected with your vision or the recovery process. Only a small number of people will require additional surgery (approximately 1 in 100 cases). The most serious complication of cataract surgery is temporary or permanent loss of vision, but the risk of this occurring is very small.

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