CATARACT SURGERY AND REFRACTIVE LENS EXCHANGE FAQs

We know that making the decision to go ahead with cataract surgery and preparing for it can be a stressful time. We have given you much information to comprehend in a short amount of time. We hope that this list of frequently asked questions can help clarify things for you after leaving our office. We suggest you go through this package with a friend or family member.

What is a cataract?

Contrary to popular belief, it is not a type of “film” that forms over the surface of the eye. It is the result of a natural change occurring inside your eye. It is a gradual clouding of the lens that can make your vision less sharp over time.

Cataracts are the most common cause of vision loss in people 50 and over.

Left untreated, cataracts have the potential of causing a complete lack of vision.

What causes cataracts?

The majority of cataracts develop on their own as part of the natural aging process.

What are the symptoms of cataracts?

Cataracts generally develop slowly and you may not even realize your vision is changing. Symptoms include:

• Blurred vision – This is one of the most common symptoms of cataracts. Changing your glasses may help but it can’t correct the problem permanently.
• Faded/dull colors – Colors appear less vivid than they once were. Certain shades can become harder to differentiate.
• Poor night vision – At first you may simply need more light to read. Over time, you may find it more difficult to see objects in the dark, particularly when driving.
• Sensitivity to light – Lights may seem uncomfortably bright, or appear to have halos around them.

Is cataract surgery right for me?

It is your doctor’s opinion that you could benefit by having cataract surgery. Since the operation is considered elective, the decision has been left to you. Cataract surgery is considered major eye surgery but complications are rare. Statistically, 95% of the patients have no complications. Around 4% have minor complications that can sometimes resolve on their own without treatment. Less than 1% have significant complications that require further treatments such as high intraocular pressure, infection inside the eye, dislocation of the implanted lens, retinal detachment, swelling or clouding of the cornea and the remote possibility of permanent loss of vision in the eye. If you have other underlying ocular diseases, such as glaucoma or retinal diseases, your vision may only improve partially or not at all.

What should I expect during cataract surgery?

During surgery, your eye’s cloudy natural lens will be replaced by an artificial intraocular lens or IOL. You will be awake for this procedure and under local anesthetic. You may be given a sedative to make sure you stay relaxed during the procedure. After the procedure, the surgeon will apply some antibiotic and anti-inflammatory drops. Patients are usually very comfortable during the procedure.

What care is required following surgery?

You are required to use eye drops following surgery (please see post op instruction sheet). You may resume your drops four hours after surgery unless otherwise specified. You are also asked to wear an eye shield at bedtime for at least one week so that you do not inadvertently rub your eye while asleep. You should wear a pair of sunglasses during the daytime for the first week when you are outside. This is so you do not rub the eye, and also to prevent dirt or dust from entering the eye. Your eyes will be dilated, so it is important to wear sunglasses when outside for UV protection. For the first week after surgery, do not lift more than 10 pounds, avoid bending over as much as possible, do not strain yourself physically and be careful not to get anything in the eye. The week after surgery, you may return to your activities, except for no swimming for four weeks. Total healing time for eye to feel normal is up to eight to twelve weeks. 

What do I do if I feel dryness and irritation after surgery?

It is common to feel dryness and irritation after surgery, commonly described as “sand in eyes” for five to six months. Generous use of artificial tears is an excellent way to relieve these symptoms.

Are floaters normal?

Floaters occur with or without surgery due to the jelly in the eye getting softer over time as we age. Sometimes cataract surgery can accelerate this process and floaters can be different or new after cataract surgery. If you have a shower of new floaters or flashes of light, or if you see a dark veil or curtain come across your vision, contact your doctor immediately.

How long does cataract surgery take?

The typical cataract procedure lasts 20 minutes.

What should my eye surgeon know on the day of surgery?

Be sure to tell the nurses when you arrive if you cannot lie on your back comfortably for 30 – 60 minutes. Also bring all your pill bottles and medications with you in case nursing staff needs to give you any of your pills.

How long do I have to wait between cataract procedures?

Sometimes we wait one to two weeks in between surgeries, depending on your physician’s surgery schedule, although many times both eyes are done on the same day (unless your surgery needs to be done at the hospital).

What sort of results do patients experience after cataract surgery?

• Clearer vision
• Enhanced image quality
• The ability to see more and therefore do more

I have decided to go ahead with cataract surgery. What next?

Next, you will choose the IOL to be implanted into your eye. Your physician will have spoken to you about your options as far as which lens options you qualify for based on their initial visit with you. Recent innovations have led to the development of many IOL designs, each with their own features and advancements. Characteristics of your eye play a critical role in lens selection.

It is important to ask yourself these questions before proceeding:

• Would you like the chance to be glasses-free after surgery, or are you fine with wearing glasses?
• Is cost an issue?

These are things you should discuss with your physician or the surgical coordinator in order to make the decision that is right for you and your lifestyle.

There are many IOL options. Why do many cataract surgery patients consider premium IOLs to be worth the investment?

• Clearer vision at all distances
• Enhanced image quality
• Correct additional conditions like blurry near vision or astigmatism

Why do some cataract surgery patients decide not to invest in premium IOLs?

• Cost
• Chance of permanent glare/halo/visual disturbances with trifocal lenses

How much will it cost to have cataract surgery?

Alberta Health pays the ophthalmologist, facility costs and the anesthetist. Alberta Health will also cover the cost of a standard lens implant but not premium lens implants. You will need to pay for your eye drops. You will likely need a change in your glasses after surgery – the cost of this is your responsibility. We ask that you see your regular optometrist six weeks after surgery for a final follow up examination and glasses prescription if needed. If you do not have an optometrist, we can arrange for you to see one of our optometrists at Alberta Eye MD. There is no charge associated with this visit.

Will my cataract return?

No. However, in a small percentage of people the posterior lens capsule behind the lens implant may become cloudy. This secondary cataract causes symptoms similar to cataracts. If this happens, your doctor can restore your vision by making an opening in the membrane using a laser. This procedure takes less than two minutes to perform, can be done while seated in the office, and is
covered by Alberta Health Care.

Now that I have made the arrangements for my chosen lens type, how do I prepare for cataract surgery?

Preparation for cataract surgery only takes place three days before surgery when you start using your eye drops. Stop eating and drinking according the Fasting Instructions on your Patient Instruction Sheet.

I am on additional eye drops for another condition (ie. Glaucoma). Do I still continue these drops?

Yes, if you are prescribed any other drops, continue these.

When will I receive the time I should be at the surgical facility on my surgery date?

The surgery coordinator will receive the time of your surgery after 3:00 PM one business day before your surgery date and you will receive a call shortly after this time.

Do I need someone to drive me and pick me up from the hospital or can I drive myself?

You must have a relative or friend drive you to and from the hospital.

If I still require glasses after the procedure, when should I get a new prescription?

We recommend that you wait at least six weeks after the procedure to obtain your new prescription due to fluctuations in your vision occurring during that period. If your requirement for glasses for driving changes, you may need to update your Driver’s License.

What is refractive lens exchange?

This is the same procedure as cataract surgery where the natural lens of the eye is removed and replaced with an artificial intraocular lens implant in patients that have not developed cataracts. It is performed so a patient can be less dependent on glasses. The risks, complications and procedure are the same as cataract surgery. Refractive lens exchange is a private procedure and is not covered by
Alberta Health Care.