TOP QUESTIONS WE HEAR FROM PATIENTS
ARE YOU AWAKE DURING CATARACT SURGERY?
Yes, typically you are awake during cataract surgery. This eliminates risks associated with general anaesthesia (being "put to sleep") and enables your cataract surgeon to communicate with you during your procedure.
If the idea of being awake during cataract surgery concerns you, fear not — you will be given oral medication before the procedure, so you are fully relaxed and feel no discomfort. You also may be given (or offered the choice of receiving) intravenous (IV) medication to help you remain calm and comfortable throughout the procedure.
The medication typically makes it difficult for most patients to remember their experience in the surgical suite after the brief 10- to 15-minute procedure has been completed and they are in the recovery area. Within a brief period of time after your procedure, you will be able to leave the surgery centre, but you cannot drive after surgery. You must have someone with you to drive you home.
CAN CATARACT SURGERY BE PERFORMED ON BOTH EYES AT THE SAME TIME?
If you have cataracts in both eyes, surgery typically is performed on one eye, and then a few days or a few weeks later, it's performed on the second eye.
This approach allows the first eye to recover and your vision in that eye to stabilise before surgery is performed on the fellow eye. Also, performing cataract surgery on each eye on separate days allows the surgeon and patient to evaluate the visual outcome of the first surgery, which might influence choices made for the second surgery.
DOES CATARACT SURGERY HURT?
There is little or no discomfort during cataract surgery. You will be awake during the procedure, but steps are taken before and during surgery, so you won't feel any pain. In fact, it's likely you won't remember much of your cataract surgery, even though you are not "put under" general anaesthesia like you are in major surgical procedures. When you arrive on your day of surgery, you typically will be given a mild sedative to help you relax. Also, anaesthetic (numbing) eye drops are applied to your eye to prevent discomfort. In some cases, you may receive additional medication intravenously during surgery to ensure you remain comfortable, and your cataract surgeon will ask you how you are feeling throughout the procedure.
Medications used before and during your cataract procedure also might make it hard for you to remember what happened during surgery, even though you are awake the entire time. As your medications wear off after the procedure, you might feel some minor eye discomfort. If so, this typically is mild and can be managed with short-term use of over-the-counter pain medication. You will be given advice on how to handle any post-surgical discomfort before you leave the surgery centre.
CAN CATARACT CAUSE BLINDNESS?
Yes — if left untreated, cataracts cause continual loss of vision, eventually leading to legal blindness or even total blindness. But when people hear the word "blindness," many assume that severe vision loss is permanent and cannot be cured. In the case of blindness caused by cataracts, vision usually can be successfully restored with cataract surgery and implantation of an intra ocular lens (IOL).
HOW IS A CATARACT REMOVED?
A small incision is made in the front surface of the eye with a scalpel or a laser. A circular hole is then cut in the front of the thin membrane (anterior capsule) that encloses the eye's natural lens. Typically, the lens is then broken into smaller pieces with a laser or an ultrasonic device so it can be more easily removed from the eye.
Once the entire lens is removed, it is replaced with a clear implant called an intra ocular lens (IOL) to restore vision. In most cases, the eye heals quickly after surgery without stitches.
CAN I HAVE CATARACT SURGERY IF I HAVE GLAUCOMA?
Yes, it's possible to have cataract surgery if you have glaucoma.
In fact, in some cases, cataract surgery can lower high eye pressure, reduce the number of medications you need to manage your glaucoma, or possibly eliminate your need for glaucoma medication altogether.
Also, it may be possible for your cataract surgeon to perform a minimally invasive type of glaucoma surgery at the same time your cataract procedure is performed to address both conditions at once.
That said, extra caution is needed to monitor the intra ocular eye pressure (IOP) of individuals with glaucoma who undergo cataract surgery. IOP may be elevated in the hours after cataract surgery for any patient. Also, spikes in IOP can sometimes occur relatively soon after surgery. For these reasons, it is essential for people with glaucoma to follow closely the instructions their cataract surgeon provides regarding use of glaucoma medications before and after their cataract procedure and to attend all scheduled visits after surgery.
Additional follow-up visits may be needed for glaucoma patients after cataract surgery to more closely monitor eye pressure and adjust medications for optimum management of their glaucoma.
WHEN CAN I RETURN TO WORK?
You will return to your home at the same day of the operation. It is strongly advised to rest for one week on average, before going back to work. This period of rest allows for optimal healing and adaptation to the new lens, thus minimising the incidence of complications.
WILL THE CATARACT RETURN AFTER THE SURGERY?
No. Once, the cataract is removed and treated, there is no way it can return again. However, posterior capsular opacity can affect the eye in which the membranes behind the implants gradually become hazy.
WHO CAN UNDERGO SURGERY?
Anyone over the age of 21 with a stable visual prescription can undergo surgery provided they have completed a full ophthalmologic examination with all the necessary refractive testing needed for the operation.
AFTER UNDERGOING AN OPERATION, HOW MUCH TIME SHOULD ONE EXPECT TO HAVE TO WAIT BEFORE RETURNING TO EVERYDAY LIFE?
Normally two days (including the day of surgery). Operations on both eyes separately requires planning in accordance with the visual condition of the patient, keeping in mind the need to avoid activities which require a lot of precision, such as driving a vehicle, for example. Low impact sports and light activities can be resumed within a week but those of higher risk, such as swimming, will require waiting for at least a month.
CAN I HAVE BOTH EYES TREATED AT THE SAME TIME?
Yes. Many patients prefer to minimise the time off work and reduce the amount of healing time they experience after surgery, so they have both eyes done during the same visit.
CAN I DRIVE MYSELF HOME AFTER SURGERY?
No. Your vision may be blurry in the first few hours after the procedure. In addition, you will be given a mild oral sedative prior to surgery and, thus, will need someone to drive you home. Many people are able to drive the next day.
WILL I HAVE TO LIMIT MY ACTIVITIES AFTER SURGERY?
You will be told to avoid strenuous activity or visually demanding tasks for at least 1-2 days after LASIK and 3 days after LASEK/PRK. Make sure to ask about specific activities that are important to you.
CAN I PLAY SPORTS RIGHT AFTER THE PROCEDURE?
No. Certain strenuous activities, contact sports and swimming should be postponed for several weeks.
HOW SOON CAN I USE EYE MAKE-UP?
It is recommended that you avoid using eye make-up for the first week after surgery to reduce the risk of infection.
CAN I GET WATER IN MY EYES?
No. You should avoid getting water in your eyes for about one week after surgery, so be careful when washing your face and hair.
IS REFRACTIVE SURGERY COVERED BY INSURANCE?
Refractive surgery is considered an elective procedure and, therefore, usually is not covered by insurance companies. Some plans will cover a portion of the screening examination. However, to be sure, check with your insurance company at the time of your evaluation.
WHAT ARE THE MOST COMMON COMPLICATIONS?
THE MOST COMMON IS EITHER OVER-CORRECTION OR UNDER-correction, both of which can be treated. Individual variation is part of any refractive surgical procedure. While everyone hopes for perfect vision, perfection is not always the result. Your expectation should be reduced dependence on glasses and contact lenses, realising that they may still be needed for some activities. Dry eyes are also common in the early post-operative period. What about severe complications? Sight-threatening complications are very rare. There is always a small risk of infection, scarring, abnormal healing patterns, or cell growth underneath the corneal flap. This may cause partial loss of vision and require further medical or surgical treatment.
WILL MY VISION BE STABLE?
Although vision may fluctuate slightly during the first few days and also shift slowly for 6 to 12 months, most of the healing is complete within 3 to 6 months. With nearly a decade of experience with PRK, we know that the procedure is stable, with no evidence of late-onset complications. LASIK has been available for about five years and, from the data collected over this period, also appears stable.
IS IT POSSIBLE THAT MY VISION COULD BE WORSE THAN BEFORE? COULD MY VISION GRADUALLY DECLINE?
There is a very slight chance that your vision could be worse. Results thus far, however, have shown excellent stability after PRK and LASIK.
WILL I BE ABLE TO WEAR CONTACT LENSES IF I STILL NEED THEM AFTER PRK OR LASIK?
Yes. In most cases, PRK and LASIK do not interfere with the use of soft contact lenses. Rigid contact lenses can sometimes be used but the fit may be more difficult. Some patients cannot wear rigid contact lenses after refractive surgery.
HOW IS PRK OR LASIK LIKELY TO AFFECT MY NEED TO USE GLASSES OR CONTACTS WHEN I GET OLDER?
By middle age, all people need help reading. If your nearsightedness is permanently eliminated by PRK or LASIK, you may need to start using reading glasses in your forties.
WILL I NEED TO USE EYE DROPS?
Depending on your specific procedure, eye drops may be needed for anywhere from three days to six months, but not permanently.